GLACIER PEAK PAIN CARE PLLC
NPI 1568909836
Pain Medicine - Interventional Pain Medicine in Clinton, UT
NPI Status: Active since January 25, 2017
- Organization
- Pain Medicine
- Interventional Pain Medicine
- Accepts Insurance
- CLIA Number: 46D2277181
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-22-2027
About GLACIER PEAK PAIN CARE PLLC
This page provides the complete NPI Profile along with additional information for Glacier Peak Pain Care Pllc, a provider established in Clinton, Utah operating as a Pain Medicine, focusing in interventional pain medicine . The healthcare provider is registered in the NPI registry with number 1568909836 assigned on January 2017. The practitioner's primary taxonomy code is 208VP0014X with license number 9777824-1205 (UT). The provider is registered as an organization and their NPI record was last updated May 2025. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Kirsten E Baca Md (Member)
- NPI
- 1568909836
- Provider Name
- GLACIER PEAK PAIN CARE PLLC
- Entity Type
- Organization
- Location Address
- 1407 N 2000 W CLINTON, UT 84015
- Location Phone
- (385) 333-7123
- Mailing Address
- 1407 N 2000 W CLINTON, UT 84015
- Mailing Phone
- (385) 333-7123
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-25-2017
- Last Update Date
- 05-06-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pain Medicine Interventional Pain Medicine
- Taxonomy Code
- 208VP0014X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 9777824-1205
- License State
- UT
- Taxonomy Description
- Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
- Bronze 4 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 6 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Healthy Premier Bronze HSA - EPO
- Healthy Premier Expanded Bronze Standard - EPO
- Healthy Premier Gold Copay - EPO
- Healthy Premier Gold Standard - EPO
- Healthy Premier Silver Copay - EPO
- Healthy Premier Silver Standard - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 46D2277181
- Facility Type
- Physician Office
- Certificate Effective Date
- February 23, 2025
- Certificate Expiration Date
- February 22, 2027
- Laboratory Director
- KIRSTEN E. BACA
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Glacier Peak Pain Care Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for GLACIER PEAK PAIN CARE PLLC
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 5 | 6 | 8 | 9 | 0 | 9 | 8 | 3 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 12 | 8 | 18 | 0 | 18 | 8 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 1 + 2 + 8 + 1 + 8 + 0 + 1 + 8 + 8 + 6 + 24 = 74 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 74 = 6 | 6 | ||||||||
The NPI number 1568909836 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1437503661 | CHRISTINE MARIE HERZOG COLEMAN ACMHCE Individual | Counselor (Mental Health) | 1407 N 2000 W SUITE D CLINTON, UT 84015 (801) 855-7999 |
| 1871776146 | PHYLLIS M TRONRUD M.C. Individual | Counselor (Professional) | 1407 N 2000 W SUITE D CLINTON, UT 84015 (801) 971-5550 |
| 1356509897 | KIRSTEN E BACA MD Individual | Pain Medicine (Interventional Pain Medicine) | 1407 N 2000 W CLINTON, UT 84015 (385) 333-7123 |
| 1639644347 | YOLANDA SUE BROWN MT Individual | Massage Therapist | 1407 N 2000 W CLINTON, UT 84015 (801) 668-5396 |
| 1295576957 | RISHA PAYNE LMT Individual | Massage Therapist | 1407 N 2000 W WEST POINT, UT 84015 (801) 835-8040 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1568909836, enumerated in the NPI registry as an "organization" on January 25, 2017
The provider is located at 1407 N 2000 W Clinton, Ut 84015 and the phone number is (385) 333-7123
This medical organization specializes in Pain Medicine with taxonomy code 208VP0014X with a focus in Interventional Pain Medicine
The provider might be accepting Accepts: Aetna CVS Health, Molina Healthcare and University. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 46D2277181 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on January 25, 2017. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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