Wasatch Optimal Wellness Clinic LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

WASATCH OPTIMAL WELLNESS CLINIC LLC

Practice address

1716 N Highway 40 Ste 200
Heber City, UT 84032-4677

Phone

(435) 800-6969

NPI assigned

Apr 5, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin Fogg, MD

Title

Medical Director / Coo

Phone

(435) 800-6969

Specialties & licenses 1

Addresses

Other names 1

• WOW Clinic Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1712275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758499200000",
    "number": "1508619040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 N HIGHWAY 40 STE 200",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840324677",
            "telephone_number": "435-800-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 N HIGHWAY 40 STE 200",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840324677",
            "telephone_number": "435-800-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASATCH OPTIMAL WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-05",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A",
        "authorized_official_last_name": "FOGG",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR / COO",
        "authorized_official_telephone_number": "435-800-6969",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WOW Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wasatch County Health Department
• Wasatch County School District
• Wasatch Crest Recovery
• Wasatch Family Dentistry
• Wasatch Medicine LLC
• Wasatch Physical Therapy Co
• Wasatch Senior and Family Care LLC
• Wasatch TMS LLC
• Jordan Washburn
• Christy Anne Watt, RDN

• Health Service Clinic/Center in Heber City, UT
• Providers in Heber City, UT by specialty
• Health Service Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.