Cache Valley Medical and Wellness

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

CACHE VALLEY MEDICAL AND WELLNESS

Practice address

196 S 100 W
Logan, UT 84321-5233

Phone

(435) 755-0434

Fax

(435) 755-0439

NPI assigned

Nov 30, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Benita Jo Quakenbush-Roberts, PH.D.

Title

Ceo

Phone

(435) 755-0434

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1790087559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3443",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843233443",
            "telephone_number": "435-755-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 S 100 W",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843215233",
            "telephone_number": "435-755-0434",
            "fax_number": "435-755-0439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CACHE VALLEY MEDICAL AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-30",
        "last_updated": "2010-11-30",
        "status": "A",
        "authorized_official_last_name": "QUAKENBUSH-ROBERTS",
        "authorized_official_first_name": "BENITA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "435-755-0434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cache Valley Cardiology PC
• Cache Valley Center for Couples and Families
• Cache Valley Dental Associates LLC
• Cache Valley Eye Associates, Inc.
• Cache Valley Eye Associates, PLLC
• Cache Valley Midwifery Group (Cache Valley Birth Center)
• Cache Valley Oral & Facial Surgery, Inc.
• Cache Valley Oxygen Inc
• Cache Valley Pathology, LLC
• Cache Valley Pediatric Dentistry

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.