Diabetes Relief Utah Ogden LLC

Primary specialty

Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X

Legal business name

DIABETES RELIEF UTAH OGDEN LLC

Practice address

2086 N 1700 W Ste D
Layton, UT 84041

Phone

(385) 515-4100

Fax

(385) 351-1150

NPI assigned

Apr 26, 2017

Organization subpart

No

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

Authorized official

Name

Kimberly Long

Title

Pca/Credentialing

Phone

(385) 515-4100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

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

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Victor Venegas

  • Nurse Practitioner
  • Murray, UT
  • NPI 1114504461
  Medicare reassignment Care Compare group NPD
• Shelly Poole Messerly, P.A.

  • Physician Assistant
  • Layton, UT
  • NPI 1073868550
  Medicare reassignment Care Compare group
• Natalie M Parkin, PAC

  • Physician Assistant
  • Bountiful, UT
  • NPI 1215211107
  Medicare reassignment Care Compare group
• Jennifer Marie Hadley, DNP, AGACNP

  • Acute Care Nurse Practitioner
  • Salt Lake City, UT
  • NPI 1184102212

  Multi-Specialty

  Medicare reassignment NPD
• Brian Willard Loveridge, MD

  • Emergency Medicine Physician
  • Layton, UT
  • NPI 1720080369
  Medicare reassignment NPD
• Justin W Mansfield, M.D.

  • Internal Medicine Physician
  • Ogden, UT
  • NPI 1699707059
  Medicare reassignment NPD
• Jeffrey Scott Adams, PAC

  • Physician Assistant
  • Layton, UT
  • NPI 1689791709
  Medicare reassignment
• Sabrina Nelson, PA

  • Physician Assistant
  • Portland, OR
  • NPI 1891170064

  UT

  Medicare reassignment

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534291200000",
    "number": "1619402799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2086 NORTH 1700 WEST",
            "address_2": "STE. D",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "84041",
            "telephone_number": "385-515-4100",
            "fax_number": "385-351-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2086 N 1700 W STE D",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "84041",
            "telephone_number": "385-515-4100",
            "fax_number": "385-351-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES RELIEF UTAH OGDEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-26",
        "last_updated": "2018-08-15",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PCA/CREDENTIALING",
        "authorized_official_telephone_number": "385-515-4100"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• R. Ferris Derbidge, RPH
• Camille Derricott
• Corbin James Desanti
• Laura Deuel, CPCI
• Lara Deveraux, LCSW
• Diabetes Specialty Center
• Tracie Dawn Diamond
• Cottie E Diaz
• Frida Angeles Diaz
• Vincent John Diaz

• Infusion Therapy Clinic/Center in Layton, UT
• Providers in Layton, UT by specialty
• Infusion Therapy Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.