Medela Wound Care, LLC

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

Organization subpart

No

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

Specialties & licenses 1

Addresses

Locations

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": []
}

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• Margaret Patricia Mecham
• Sharie Mecham
• Medallion Manor Inc.
• Marsha K Medford, APRN
• Karla M Medina
• Mitziana Medina
• Mediserve LLC
• Hope Medley, CSW

• All providers in Provo, UT
• Physical Medicine & Rehabilitation Physician in Utah

• 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.