Axial-Im

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

Legal business name

AXIAL-IM

Practice address

3898 W Innovation Dr Ste B
Riverton, UT 84065-6038

Phone

(801) 302-0660

Fax

(801) 302-2239

NPI assigned

Apr 17, 2019

Last updated

Mar 5, 2025By 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

Mollie S Wilson

Title

Authorized Official

Phone

(913) 499-9885

Specialties & licenses 3

Addresses

Other names 1

• Axial Medicine Other name

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 2

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.

• David P Bowman, D.O.

  • Family Medicine Physician
  • Stansbury Park, UT
  • NPI 1053486076
  Medicare reassignment NPD
• Elizabeth Janine Hugie, DNP-FNP

  • Family Nurse Practitioner
  • West Valley City, UT
  • NPI 1518665983
  Medicare reassignment NPD

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741132800000",
    "number": "1740843697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95411",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840950411",
            "telephone_number": "801-210-2776",
            "fax_number": "801-972-5707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3898 W INNOVATION DR STE B",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840656038",
            "telephone_number": "801-302-0660",
            "fax_number": "801-302-2239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1264 W Village Main Dr Unit A",
            "address_purpose": "LOCATION",
            "city": "West Valley City",
            "state": "UT",
            "postal_code": "841191952",
            "country_code": "US",
            "telephone_number": "801-210-2776 x403",
            "fax_number": "801-972-5707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AXIAL-IM",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-17",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MOLLIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "913-499-9885"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Axial Medicine",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Axial Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Aspire Psychological LLC
• Aspiro Group Inc
• Marcellus Saka Assiago, MD
• Mikaela Ann Atkins, BSN, RN, CNRN
• Jonathan J Atzet, MD
• Lauren Nicole Pabst Ayala, DPT
• Annie Elizabeth Ayre
• B. Charles Pugh D.D.S., P.C.
• Hannah Preeth Backman, DNP
• Ellois Wilson Bailey, DNP, APRN, PMHNP-BC

• Neuromusculoskeletal Medicine & OMM Physician in Riverton, UT
• Providers in Riverton, UT by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.