OrganizationActive
Glacier Peak Pain Care PLLC
NPI 1568909836 · Interventional Pain Medicine Physician · Clinton, UT
Provider details
- NPI number
- 1568909836
- Entity type
- Organization
- Primary specialty
- Interventional Pain Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kirsten Baca, Member(443) 413-3130
- License
- 9777824-1205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(70/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1407 N 2000 W
Clinton, UT 84015-8562
Phone: (385) 333-7123
Street-level locationGet directions
Mailing address
1407 N 2000 W
Clinton, UT 84015-8562
Registry dates
- Enumerated
- 2017-01-25
- Last updated
- 2025-05-06
- Certified
- 2025-05-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.