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IVY LANE PEDIATRICS, LLC
NPI 1083635692
Home Health in South Ogden, UT

Active since July 21, 2006CLIA 46D2022083 · Waiver
5974 FASHION POINT DR STE 230, SOUTH OGDEN, UT 84403(801) 774-9698(801) 728-0641 Get Directions Write a Review

NPPES record last updated: January 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 21, 2022, May 24, 2021 (2 updates tracked since 2021).

About Ivy Lane Pediatrics, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IVY LANE PEDIATRICS, LLC (NPI 1083635692) is a healthcare organization registered as a home health in South Ogden, Utah and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through January 28, 2028 and lists Wyndam Reeve, Administrator, as its authorized official.

NPPES Registry Identity

NPI1083635692
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NameIVY LANE PEDIATRICS, LLC
Location Address5974 FASHION POINT DR STE 230South Ogden, UT 84403-4805
Mailing Address5974 Fashion Point Dr Ste 230South Ogden, UT 84403-4805 · (801) 774-9698 · Fax (801) 728-0641
Phone(801) 774-9698
Fax(801) 728-0641
Organization SubpartNo
Authorized OfficialWyndam ReeveAdministrator · (801) 774-9698
Enumeration DateJuly 21, 2006
Last NPPES UpdateJanuary 21, 20222 updates tracked since enumeration
NPPES CertifiedJanuary 21, 2022
✔ NPI 1083635692 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
5974 FASHION POINT DR STE 230, South Ogden, UT 84403
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include University of Utah Health Plans.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 46D2022083

Ivy Lane Pediatrics Dba Amazing Care Home Health · South Ogden, UT
Active · expires Jan 28, 2028
CLIA Number46D2022083
Laboratory TypeHome Health Agency
Certificate Effective DateJanuary 29, 2026
Certificate Expiration DateJanuary 28, 2028
Laboratory DirectorKatherine Reid
Laboratory Phone(801) 774-9698
Laboratory LocationIvy Lane Pediatrics Dba Amazing Care Home Health5974 Fashion Point Dr, Suite 230, South Ogden, UT 84403
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ivy Lane Pediatrics, LLC's NPI number?

The NPI number for Ivy Lane Pediatrics, LLC is 1083635692. It was assigned to this organization in the NPPES registry on July 21, 2006.

Where is Ivy Lane Pediatrics, LLC located?

Ivy Lane Pediatrics, LLC is located at 5974 Fashion Point Dr Ste 230, South Ogden, UT 84403. The listed phone number is (801) 774-9698.

What is Ivy Lane Pediatrics, LLC's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

Does Ivy Lane Pediatrics, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D2022083) is associated with this NPI, valid through January 28, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Ivy Lane Pediatrics, LLC accept?

Health plans from University of Utah Health Plans list Ivy Lane Pediatrics, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ivy Lane Pediatrics, LLC was last updated on January 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.