Active NPI
Medela Wound Care, LLC
- Physical Medicine & Rehabilitation Physician
- Provo, UT
National Provider Identifier
1801437645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- Legal business name
- MEDELA WOUND CARE, LLC
- Practice address
- 2230 N University Pkwy Ste 6B
Provo, UT 84604-1584 - Phone
- (801) 440-3034
- NPI assigned
- Oct 2, 2019
- Last updated
- Oct 2, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Joseph Clark Fyans, MD
- Title
- Owner
- Phone
- (801) 440-3034
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | Primary |
Addresses
Primary practice location
2230 N University Pkwy Ste 6B
Provo, UT 84604-1584
Mailing address
5064 N Ravencrest LN
Lehi, UT 84043-7725
Phone (801) 440-3034
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
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.
-
- Physical Medicine & Rehabilitation Physician
- Sandy, UT
- NPI 1447431317
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569974400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1569974400000",
"number": "1801437645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5064 N RAVENCREST LN",
"city": "LEHI",
"state": "UT",
"postal_code": "840437725",
"telephone_number": "801-440-3034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2230 N UNIVERSITY PKWY STE 6B",
"city": "PROVO",
"state": "UT",
"postal_code": "846041584",
"telephone_number": "801-440-3034"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDELA WOUND CARE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-10-02",
"last_updated": "2019-10-02",
"status": "A",
"authorized_official_last_name": "FYANS",
"authorized_official_first_name": "JOSEPH",
"authorized_official_middle_name": "CLARK",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "801-440-3034",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.