Organization Active NPI

Complete Care Clinic PLLC

  • Preferred Provider Organization
  • Tooele, UT
National Provider Identifier
1639196710
Registry record updated May 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
2807191205 Issued in UT
Legal business name
COMPLETE CARE CLINIC PLLC
Practice address
15 N 100 E
Tooele, UT 84074-2101
Phone
(435) 882-6618
Fax
(435) 843-3774
NPI assigned
Jul 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2015

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

Authorized official

Name
Dr. Paul Anthony Satter, MDNPI 1528092475
Title
Owner
Phone
(435) 882-6618

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 2807191205 UT Primary

Addresses

Primary practice location

15 N 100 E
Tooele, UT 84074-2101

Mailing address

15 N 100 E
Tooele, UT 84074-2101
Phone (435) 882-6618

Other identifiers 1

IdentifierTypeStateIssuer
261517430001MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050825001041 UT Part B Supplier - Clinic/Group Practice 9931130291 Receives reassigned benefits from 1 practitioner
Practice locations: Tooele, UT

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D0888472Complete Care Clinic15 N 100 E, Tooele, UT 84074Provider-performed microscopyJul 6, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432684800000",
    "number": "1639196710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 N 100 E",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840742101",
            "telephone_number": "435-882-6618",
            "fax_number": "435-843-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 N 100 E",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840742101",
            "telephone_number": "435-882-6618",
            "fax_number": "435-843-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE CARE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2015-05-27",
        "status": "A",
        "authorized_official_last_name": "SATTER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-882-6618",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "UT",
            "license": "2807191205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261517430001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tooele, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; 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.