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ROSE CREEK PEDIATRICS LLC NPI 1750985420


NPI Information

NPI: 1750985420
Provider Name: ROSE CREEK PEDIATRICS, LLC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 46D2212842

Address:
4121 W 13400 S UNIT B
RIVERTON, UT
ZIP 84096
Phone: (801) 842-7366
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ROSE CREEK PEDIATRICS, LLC is a pediatrics in Riverton, UT. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. ROSE CREEK PEDIATRICS, LLC NPI is 1750985420. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4121 W 13400 S UNIT B
RIVERTON, UT
ZIP 84096-412
Phone: (801) 842-7366

The provider's authorized official is Woodrow Cannon Marriott .
The authorized official title is Managing Member and has the following contact phone number (801) 842-7366.

The CLIA number assigned to this NPI record is 46D2212842 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/24/2020 and was last updated on 11/24/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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