Provider Demographics
NPI:1780002188
Name:VALLEY OBSTETRICS AND GYNECOLOGY, P.C.
Entity Type:Organization
Organization Name:VALLEY OBSTETRICS AND GYNECOLOGY, P.C.
Other - Org Name:AF CNMS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RASMUSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-374-1802
Mailing Address - Street 1:585 N 500 W
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84601-1548
Mailing Address - Country:US
Mailing Address - Phone:801-374-1801
Mailing Address - Fax:801-216-8357
Practice Address - Street 1:1248 E 90 N STE 300
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2956
Practice Address - Country:US
Practice Address - Phone:801-756-1577
Practice Address - Fax:801-216-8357
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALLEY OBSTETRICS AND GYNECOLOGY, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-02
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT215423-4402367A00000X
UT359986-4402367A00000X
UT7370494-4402367A00000X
UT5665692-4402367A00000X
UT189113-4402367A00000X
UT334308-4402367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1497717052OtherNPI
UT1609419043OtherNPI
UT1710940952OtherSEAMONS NPI
UT1952615205OtherNPI
UT1043963572OtherHODGES NPI
UT1386974525OtherNELSON NPI
UT1598778771OtherNPI
UT1639539521OtherDIVALL NPI
UT1679168264OtherNPI
UT1841749215OtherMEIDELL NPI