Cottonwood Medical Clinic Inc

Primary specialty

Acute Care Clinical Nurse SpecialistTaxonomy code 364SA2100X

License

2121144405 Issued in UT

Legal business name

COTTONWOOD MEDICAL CLINIC INC

Practice address

8822 S Redwood Rd Ste 103
West Jordan, UT 84088-9341

Phone

(801) 281-5775

Fax

(801) 823-0213

NPI assigned

Jan 21, 2015

Organization subpart

No

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

Authorized official

Name

Ann Lapolla, APRNNPI 1609276484

Title

Owner

Phone

(801) 281-5775

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ann Elizabeth Lapolla, DNP, APRN

  • Acute Care Nurse Practitioner
  • Salt Lake City, UT
  • NPI 1609276484
  Medicare reassignment Authorized official
• Lynda R Healey, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • West Jordan, UT
  • NPI 1396148896
  Medicare reassignment
• Sandra Bethel Jense, APRN

  • Acute Care Nurse Practitioner
  • Salt Lake City, UT
  • NPI 1104258763
  Medicare reassignment
• Gitanjali Sharma, ACNP-BC

  • Acute Care Nurse Practitioner
  • Salt Lake City, UT
  • NPI 1497164180
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1972992477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8414 S KINGS COVE DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216064",
            "telephone_number": "801-231-4932",
            "fax_number": "866-936-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8822 S REDWOOD RD STE 103",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840889341",
            "telephone_number": "801-281-5775",
            "fax_number": "801-823-0213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COTTONWOOD MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-21",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "LAPOLLA",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-281-5775",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "UT",
            "license": "2121144405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2121144405",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nevayah Corbett
• Michelle Corona, SUDC
• Toni Marie Corsey, RPH
• Karissa Coston
• Cottonwood Hearing Center
• Courageous Hearts ABA LLC
• Azucena Covarrubias
• Misty Covington, CSW
• James N Cowart, LPC
• Alana Elizabeth Cowgill

• Acute Care Clinical Nurse Specialist in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Acute Care Clinical Nurse Specialist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.