MEDICARE: INTEGRATED TMS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
2	2084P0800X	Psychiatry Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336718204
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED TMS LLC

Provider Business Mailing Address
First Line	:	1664 S DIXIE DR STE 102
Second Line	:	BLD E
City	:	SAINT GEORGE
State	:	UT
Zip	:	84770-7327
Country	:	US
Telephone Number	:	435-767-8840
Fax Number	:	435-703-6003

Provider Business Practice Location Address
First Line	:	1664 S DIXIE DR STE 102
Second Line	:	BLD E
City	:	SAINT GEORGE
State	:	UT
Zip	:	84770-7327
Country	:	US
Telephone Number	:	435-767-8840
Fax Number	:	435-703-6003

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	FORREST JIM WOLVERTON
Credential	:
Telephone Number	:	435-767-8840

Provider Enumeration Date	:	06/23/2021
Last Update Date	:	06/28/2021

Similar Medicare Providers

1942541222 — SPORT SPINE & WELLNESS, PLLC
Practice Location Address:

1664 S DIXIE DR , STE. F-103
ST GEORGE, UT
84770-7327

Practice Phone: 435-703-9676
Practice Fax:

1063892339 — CARA LOGAN LCSW
Practice Location Address:

1664 S DIXIE DR , C-102
ST GEORGE, UT
84770-7327

Practice Phone: 435-673-4494
Practice Fax:

1760047427 — WES & CO.
Practice Location Address:

5524 MULBERRY DR
NORTH PRINCE GEORGE, VA
23860-7327

Practice Phone: 804-452-7686
Practice Fax:

1831329671 — MRS. ERIN LOFTON CAIN M.A., SLP
Practice Location Address:

6117 BEECHGROVE LN
SAINT FRANCISVILLE, LA
70775-7327

Practice Phone: 225-276-2115
Practice Fax:

1346695582 — MCCLAY ADULT DAY CENTER LLC
Practice Location Address:

3821 MCCLAY RD
SAINT PETERS, MO
63376-7327

Practice Phone: 636-922-9595
Practice Fax:

1457864944 — MCCLAY HEALTH AND REHAB LLC
Practice Location Address:

3801 MCCLAY RD
SAINT PETERS, MO
63376-7327

Practice Phone: 636-244-3323
Practice Fax:

Directions to “INTEGRATED TMS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.