NPIMap

Organization Active NPI

Utah Weight Loss & Natural Hormone Clinic

  • Primary Care Clinic/Center
  • Grants Pass, OR
National Provider Identifier
1619286879
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
201603205NP-PP Issued in OR
Legal business name
UTAH WEIGHT LOSS & NATURAL HORMONE CLINIC
Doing business as
Utah Weight Loss & Natural Hormone Clinic
Practice address
1378 SW David Dr
Grants Pass, OR 97527-6429
Phone
(801) 272-1246
NPI assigned
Oct 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Authorized official

Name
Kathryn R Desantis, FNPNPI 1891796496
Title
Owner, Provider
Phone
(801) 272-1246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 201603205NP-PP OR Primary
Primary Care Clinic/Center 261QP2300X 275822-8900 UT

Addresses

Primary practice location

1378 SW David Dr
Grants Pass, OR 97527-6429

Mailing address

1378 SW David Dr
Grants Pass, OR 97527-6429
Phone (801) 272-1246

Other names 1

  • Utah Weight Loss & Natural Hormone Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

2046 E Murray Holladay Rd
Ste 204
Holladay, UT 84117
Phone (801) 272-1246

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491350400000",
    "number": "1619286879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1378 SW DAVID DR",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975276429",
            "telephone_number": "801-272-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1378 SW DAVID DR",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975276429",
            "telephone_number": "801-272-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH WEIGHT LOSS & NATURAL HORMONE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-05",
        "last_updated": "2017-04-05",
        "status": "A",
        "authorized_official_last_name": "DESANTIS",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER, PROVIDER",
        "authorized_official_telephone_number": "801-272-1246",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OR",
            "license": "201603205NP-PP",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "UT",
            "license": "275822-8900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Utah Weight Loss & Natural Hormone Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; 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.