Healing Edge Medical Group Ut PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

HEALING EDGE MEDICAL GROUP UT PLLC

Practice address

10 W Broadway FL 7
Salt Lake City, UT 84101-2060

Phone

(615) 499-3165

NPI assigned

Jul 2, 2024

Last updated

Jul 2, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lev Grinman, MD

Title

Partner

Phone

(615) 499-3165

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Frank Suppa, D.O

  • Family Medicine Physician
  • Far Rockaway, NY
  • NPI 1700199213
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1508602251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 S OYSTER BAY RD # 2059",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118033301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 W BROADWAY FL 7",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841012060",
            "telephone_number": "615-499-3165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 W Broadway",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841012002",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEALING EDGE MEDICAL GROUP UT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "GRINMAN",
        "authorized_official_first_name": "LEV",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "615-499-3165",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allyson Headman
• Hailey Headman
• Victoria Ihrman Heagy, DNP
• Darion Heald, MD
• Lori J. Healey, MD
• Healing Feathers LLC
• Healing Pathways Therapy Center
• Healing With Jhuck (Prism Therapy SLC)
• Danielle Healis, MS, MCHES
• Healogics Specialty Physicians of Utah, LLC

• Internal Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Internal Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.