NPIMap

Organization Active NPI

Integrated Functional Medicine, LLC

  • Durable Medical Equipment & Medical Supplies
  • Bountiful, UT
National Provider Identifier
1861266256
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
INTEGRATED FUNCTIONAL MEDICINE, LLC
Practice address
458 N 500 W
Bountiful, UT 84010-6948
Phone
(801) 905-8253
NPI assigned
Nov 7, 2023
Last updated
Nov 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Authorized official

Name
Kirk Wersland, DCNPI 1558353979
Title
Owner
Phone
(801) 292-9355

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
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

458 N 500 W
Bountiful, UT 84010-6948

Mailing address

458 N 500 W
Bountiful, UT 84010-6948
Phone (801) 292-9355

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Integrated Wellness458 N 500 W, Bountiful, UT 84010-6948(801) 292-9355 (TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf Accepts assignmentParticipating since Dec 3, 2013

National Provider Directory

National Provider Directory
Tax ID family
Integrated Functional Medicine LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the 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": "1699315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1861266256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "458 N 500 W",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106948",
            "telephone_number": "801-292-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "458 N 500 W",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106948",
            "telephone_number": "801-905-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED FUNCTIONAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-07",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "WERSLAND",
        "authorized_official_first_name": "KIRK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-292-9355",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.