Healthcare Provider Details

I. General information

NPI: 1356825350
Provider Name (Legal Business Name): ROBERT BIXLER CCM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2018
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 S REDWOOD RD BLDG E
WEST JORDAN UT
84084-4007
US

IV. Provider business mailing address

7601 S REDWOOD RD BLDG E
WEST JORDAN UT
84084-4007
US

V. Phone/Fax

Practice location:
  • Phone: 801-233-8670
  • Fax:
Mailing address:
  • Phone: 801-233-8670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14288116-3502
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: