Organization Active NPI

Medela Wound Care, LLC

  • Physical Medicine & Rehabilitation Physician
  • Provo, UT
National Provider Identifier
1801437645
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
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, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

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

Authorized official

Name
Dr. Joseph Clark Fyans, MDNPI 1447431317
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)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 Directory

Practitioners & 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.

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.

Verify at the official NPI Registry.