network|NPI|TIN|Name|FirstName|MI|LastName|Degree|Specialty|Address|City|State|Zip|Phone|TermDate|ReportDate
WISE|1144602822|611696015||KARL|T|MARTINEAU|DO|Psychiatry|1200 E 3900 S|SALT LAKE CITY|UT|84124|8012687111|2022-06-13|2022-12-15
WISE|1407921570|208190990||BRUCE||WEBER|DC|Chiropractic|205 MAIN ST|PINE BLUFFS|WY|82082|3072453766|2023-04-23|2022-12-15
WISE|1407921570|208190990||BRUCE||WEBER|DC|Chiropractic|7124 COMMONS DR UNIT D|CHEYENNE|WY|82009|3076356777|2023-04-23|2022-12-15
WISE|1427040823|800223062||DERRICK||WALKER|DO|General Surgery|1741 N 2000 W STE 3|OGDEN|UT|84404|4356952273|2022-08-27|2022-12-15
WISE|1427040823|800223062||DERRICK||WALKER|DO|General Surgery|2850 N 2000 W STE 101|OGDEN|UT|84404|4356952273|2022-08-27|2022-12-15
WISE|1427040823|800223062||DERRICK||WALKER|DO|General Surgery|970 MEDICAL DR STE 202|BRIGHAM CITY|UT|84302|4356952273|2022-08-27|2022-12-15
WISE|1427040823|800223062||DERRICK||WALKER|DO|General Surgery|984 MEDICAL DR STE 4|BRIGHAM CITY|UT|84302|4357230329|2022-08-27|2022-12-15
WISE|1427040823|800223062||DERRICK||WALKER|DO|General Surgery|P.O. BOX 405473|ATLANTA|GA|30384|6153737600|2022-08-27|2022-12-15
WISE|1437205028|870281028|REVERE HEALTH SURGERY CENTER|||||Ambulatory Surgery Center|1175 E 50 S|AMERICAN FORK|UT|84003|8013758858|2022-11-30|2022-12-15
WISE|1437205028|870281028|REVERE HEALTH SURGERY CENTER|||||Ambulatory Surgery Center|P.O. BOX 30079|SALT LAKE CITY|UT|84130|8013758858|2022-11-30|2022-12-15
WISE|1457766982|800223062||NOAH|L|WRIDE|MD|General Surgery|1741 N 2000 W STE 3|OGDEN|UT|84404|4356952273|2022-10-15|2022-12-15
WISE|1457766982|800223062||NOAH|L|WRIDE|MD|General Surgery|970 MEDICAL DR STE 202|BRIGHAM CITY|UT|84302|4356952273|2022-10-15|2022-12-15
WISE|1497199228|870281028||RONALD||CHONG-YIK|MD|Interventional Cardiology|1055 N 500 W STE 101 BLDG C|PROVO|UT|84604|8013734366|2022-12-02|2022-12-15
WISE|1508155193|450579013||SEAN|F|EDMUNDS|MD|Obstetrics and Gynecology|1140 E 3900 S STE 400|SALT LAKE CITY|UT|84124|8012686811|2022-09-10|2022-12-15
WISE|1508155193|450579013||SEAN|F|EDMUNDS|MD|Obstetrics and Gynecology|850 E 300 S STE 1|SALT LAKE CITY|UT|84102|8013221214|2022-09-10|2022-12-15
WISE|1629430046|870280459||CHADWICK|M|DENSLEY|DO|Obstetrics and Gynecology|12842 S 3600 W STE 200 STE 200|RIVERTON|UT|84065|8012854800|2022-11-01|2022-12-15
WISE|1659721934|770701557||SHAUN|T|GUNDERSEN|PA|Family Practice|348 E 4500 S STE 300|SALT LAKE CITY|UT|84107|8012662777|2022-08-13|2022-12-15
WISE|1720497597|462252776||DERRICK|M|PICKERING|NP|Nurse Practitioner|1528 N COMMERCE DR STE 204 STE 204|SARATOGA SPRINGS|UT|84045|8017668427|2022-11-09|2022-12-15
WISE|1720497597|462252776||DERRICK|M|PICKERING|NP|Nurse Practitioner|155 N 400 W STE B6 STE B6|OREM|UT|84057|8012241300|2022-11-09|2022-12-15
WISE|1720497597|462252776||DERRICK|M|PICKERING|NP|Nurse Practitioner|226 N 1100 E STE A STE A|AMERICAN FORK|UT|84003|8018553841|2022-11-09|2022-12-15
WISE|1720497597|462252776||DERRICK|M|PICKERING|NP|Nurse Practitioner|275 W 200 N|LINDON|UT|84042|8017961333|2022-11-09|2022-12-15
WISE|1720497597|462252776||DERRICK|M|PICKERING|NP|Nurse Practitioner|3000 N TRIUMPH BLVD STE 220 STE 220|LEHI|UT|84043|8017534650|2022-11-09|2022-12-15
WISE|1720497597|462252776||DERRICK|M|PICKERING|NP|Nurse Practitioner|3943 E PONY EXPY PKWY STE 120 STE 120|EAGLE MOUNTAIN|UT|84005|8017895566|2022-11-09|2022-12-15
WISE|1720497597|462252776||DERRICK|M|PICKERING|NP|Nurse Practitioner|680 E MAIN ST|LEHI|UT|84043|8017681699|2022-11-09|2022-12-15
WISE|1720497597|462252776||DERRICK|M|PICKERING|NP|Nurse Practitioner|830 N 2000 W|PLEASANT GROVE|UT|84062|8017563511|2022-11-09|2022-12-15
WISE|1730839861|462252776||BRITTNEY|M|OLSON|MSN|Family Practice|275 W 200 N|LINDON|UT|84042|8017961333|2022-12-02|2022-12-15
WISE|1730839861|462252776||BRITTNEY|M|OLSON|MSN|Family Practice|830 N 2000 W|PLEASANT GROVE|UT|84062|8017563511|2022-12-02|2022-12-15
WISE|1790207561|463111656||HEATHER||TRAEDEN|BCBA|ABA Therapy|1893 E SKYLINE DR|OGDEN|UT|84403|8016831062|2022-11-16|2022-12-15
WISE|1790207561|463111656||HEATHER||TRAEDEN|BCBA|ABA Therapy|327 W GORDON AVE STE 2|LAYTON|UT|84041|8016831062|2022-11-16|2022-12-15
WISE|1790207561|463111656||HEATHER||TRAEDEN|BCBA|ABA Therapy|415 MEDICAL DR STE A100|BOUNTIFUL|UT|84010|8016831062|2022-11-16|2022-12-15
WISE|1851368765|800701770||SANDEEP|S|TEJA|MD|Neurosurgery|1220 E 3900 S STE 4A|SALT LAKE CITY|UT|84124|8012618507|2022-09-07|2022-12-15
WISE|1851368765|800701770||SANDEEP|S|TEJA|MD|Neurosurgery|74 E KIMBALLS LN STE 330|DRAPER|UT|84020|8012625711|2022-09-07|2022-12-15
WISE|1871092569|870218917||TRINA||BURY|NP|Internal Medicine|1600 W ANTELOPE DR|LAYTON|UT|84041|8017734840|2022-08-31|2022-12-15