NPIMap

Organization Active NPI

Cache Valley Womens Center, PLLC

  • Obstetrics & Gynecology Physician
  • Logan, UT
National Provider Identifier
1922217850
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
CACHE VALLEY WOMENS CENTER, PLLC
Practice address
1325 North 600 E
#102
Logan, UT 84341
Phone
(435) 753-9999
Fax
(435) 753-0546
NPI assigned
May 21, 2007
Last updated
Feb 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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

Authorized official

Name
Jodi Sickler
Title
Office Manager
Phone
(435) 753-9999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

1325 North 600 E
#102
Logan, UT 84341

Mailing address

1325 North 600 E
#102
Logan, UT 84341
Phone (435) 753-9999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041221001026 UT Part B Supplier - Clinic/Group Practice 9032177001 Receives reassigned benefits from 8 practitioners
Practice locations: Logan, UT

National Provider Directory

National Provider Directory

Locations

1325 N 600 E
Ste 102
Logan, UT 84341
Phone (435) 753-9999

Practitioners & affiliated clinicians

Practitioners 12

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": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360627200000",
    "number": "1922217850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 NORTH 600 E",
            "address_2": "#102",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "84341",
            "telephone_number": "435-753-9999",
            "fax_number": "435-753-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 NORTH 600 E",
            "address_2": "#102",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "84341",
            "telephone_number": "435-753-9999",
            "fax_number": "435-753-0546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CACHE VALLEY WOMENS CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2013-02-12",
        "status": "A",
        "authorized_official_last_name": "SICKLER",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "435-753-9999"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.