Cedar Creek Family Health Care LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

219855-8900 Issued in UT

Legal business name

CEDAR CREEK FAMILY HEALTH CARE LLC

Practice address

453 N Main St Ste a
Tooele, UT 84074-1654

Phone

(801) 232-1998

NPI assigned

Nov 10, 2008

Last updated

Apr 2, 2010By 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

Lu Ann Jacobs-Peterson, APRNNPI 1396918462

Title

FNP

Phone

(801) 232-1998

Specialties & licenses 1

Addresses

Other names 1

• Majestic Oaks Family Health Care Former legal business name

Locations

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.

• Lu Ann Jacobs-Peterson, APRN FNP

  • Nurse Practitioner
  • Tooele, UT
  • NPI 1396918462
  NPD (past) Authorized official

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270166400000",
    "number": "1639323280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14540 MAJESTIC OAKS LN",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840963645",
            "telephone_number": "801-232-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 N MAIN ST STE A",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840741654",
            "telephone_number": "801-232-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR CREEK FAMILY HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-10",
        "last_updated": "2010-04-02",
        "status": "A",
        "authorized_official_last_name": "JACOBS-PETERSON",
        "authorized_official_first_name": "LU ANN",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "801-232-1998",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "UT",
            "license": "219855-8900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Majestic Oaks Family Health Care",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Sara Carstensen, PA-C
• Catherine Carter, APRN, NP-C
• Dalton Carter, DPT
• Trisha D Carter, CASE MANAGER
• Blaine Johnson Cashmore, MD
• Barbara T Cederlof
• Center for Individual Responsibility (CIRCLE Treatment)
• Shauna R. Chacon
• Norhan Aziz Chacopulos
• Chelsie M Chadwick Haynes

• Clinic/Center in Tooele, UT
• Providers in Tooele, UT by specialty
• Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2010; 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.