Integrated Wellcare, LLC.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

INTEGRATED WELLCARE, LLC.

Practice address

5168 Crus Corvi Rd
West Jordan, UT 84081-5336

Phone

(801) 358-7567

NPI assigned

Mar 25, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Jamison Sivulich

Title

Managing Member

Phone

(801) 358-7567

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269475200000",
    "number": "1982928545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5168 CRUS CORVI RD",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840815336",
            "telephone_number": "801-358-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5168 CRUS CORVI RD",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840815336",
            "telephone_number": "801-358-7567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED WELLCARE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-25",
        "last_updated": "2010-03-25",
        "status": "A",
        "authorized_official_last_name": "SIVULICH",
        "authorized_official_first_name": "JAMISON",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "801-358-7567",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2010; 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.