Central Utah Clinic, P.C.

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

CENTRAL UTAH CLINIC, P.C.

Practice address

330 Falcon Ridge Pkwy Ste 400a
Mesquite, NV 89027-8881

Phone

(801) 377-5757

Fax

(801) 418-0941

NPI assigned

Mar 11, 2019

Organization subpart

No

Name

Jed Bradley Harston

Title

Director of Payer Relations

Phone

(801) 812-5012

Tax ID family

Walstir H Fonseca MD11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

• Central Utah Clinic, P.C.

  • Orthopaedic Surgery Physician
  • American Fork, UT
  • NPI 1134346976
  NPD tax ID
• Central Utah Clinic, P.C.

  • Multi-Specialty Clinic/Center
  • American Fork, UT
  • NPI 1144439068
  NPD tax ID
• Central Utah Clinic, P.C.

  • Eyewear Supplier
  • Murray, UT
  • NPI 1265907620
  NPD tax ID
• Central Utah Clinic, P.C.

  • Non-Pharmacy Dispensing Site
  • Provo, UT
  • NPI 1316330749
  NPD tax ID
• Central Utah Clinic, P.C.

  • Radiation Therapy Radiologic Technologist
  • Provo, UT
  • NPI 1437341427
  NPD tax ID
• Central Utah Clinic, P.C.

  • Family Medicine Physician
  • Payson, UT
  • NPI 1508896838
  NPD tax ID
• Central Utah Clinic, P.C.

  • Multi-Specialty Clinic/Center
  • Salem, UT
  • NPI 1689003550
  NPD tax ID
• Revere Health PC

  • Orthopaedic Surgery Physician
  • Saratoga Springs, UT
  • NPI 1538867999
  NPD tax ID
• Revere Health PC

  • Orthopaedic Surgery Physician
  • Orem, UT
  • NPI 1780017954
  NPD tax ID
• Revere Health PC

  • Orthopaedic Surgery Physician
  • American Fork, UT
  • NPI 1891813960
  NPD tax ID

• Revere Health Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 11, 2019.

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552262400000",
    "number": "1669930475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "address_2": "ATTN: CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 FALCON RIDGE PKWY STE 400A",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890278881",
            "telephone_number": "801-377-5757",
            "fax_number": "801-418-0941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL UTAH CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-03-11",
        "status": "A",
        "authorized_official_last_name": "HARSTON",
        "authorized_official_first_name": "JED",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "DIRECTOR OF PAYER RELATIONS",
        "authorized_official_telephone_number": "801-812-5012"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revere Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Canyonlands Community Health Care
• Darian Nashae Carey
• Ronda Elizabeth Case, LCSW
• Liliana A Castaneda-Samaniego
• CCMD LLC
• Christine Jyl Christensen
• Jennifer Cisler
• City of Mesquite
• Angela Dee Clark
• Henry Larry Clark

• All providers in Mesquite, NV
• Multi-Specialty Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.