MEDICARE: GADZOOM HEALTH LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363LP2300X	Primary Care Nurse Practitioner
2	261QM1300X	Multi-Specialty Clinic/Center
3	261Q00000X	Clinic/Center
4	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
5	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1770187163
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GADZOOM HEALTH LLC

Provider Business Mailing Address
First Line	:	3401 N THANKSGIVING WAY STE 190
Second Line	:
City	:	LEHI
State	:	UT
Zip	:	84048-4157
Country	:	US
Telephone Number	:	385-454-5027
Fax Number	:

Provider Business Practice Location Address
First Line	:	3401 N THANKSGIVING WAY STE 190
Second Line	:
City	:	LEHI
State	:	UT
Zip	:	84048-4157
Country	:	US
Telephone Number	:	385-454-5027
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	BRIAN NEWBERRY
Credential	:
Telephone Number	:	385-454-5027

Provider Enumeration Date	:	11/25/2020
Last Update Date	:	12/15/2025

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Directions to “GADZOOM HEALTH LLC ” Practice Location

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