DR. KEITH H EVANS (NPI# 1033179049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033179049 |
| Entity Type | Individual |
| Full Name | DR. KEITH H EVANS |
| Credential | MD |
| Practice Address |
1140 W 500 S Vernal UT 84078-2914 |
| Mailing Address |
1140 W 500 S Ste 9 Vernal UT 84078-2912 |
| Practice Telephone | 4357896300 |
| Practice Fax Number | 4357896325 |
| Mailing Telephone | 4357896300 |
| Mailing Fax Number | 4357896325 |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2019-02-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 1612791205 | UT | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 285 W 800 S, Roosevelt, UT 840663707 | 4357256300 | 4357256325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750828406 | Keith B Evans | Clinical Nurse Specialist | 12 Lincoln Dr, Shelby, OH 44875-1482 | 2017-01-19 |
| 1942549746 | Keith Evans | Student in an Organized Health Care Education/Training Program | 56 Chestnut Ln, Pine Grove, PA 17963-8741 | 2013-02-14 |
| 1518080977 | Keith E. Evans | Physical Therapist | 3250 Hogan Rd, Sw, Atlanta, GA 30331-2830 | 2007-04-09 |
| 1215009923 | Keith Allen Evans | Dentist | 113 N Regency Dr, Bloomington, IL 61701-3515 | 2006-11-15 |
| 1992704688 | Keith Alan Evans | Chiropractor | 4220 Treadway Rd, Beaumont, TX 77706-7105 | 2005-07-15 |
| 1508116971 | Keith L Evans Jr. | Counselor | 62 Village Ln, Berwick, PA 18603-5741 | 2012-09-13 |
| 1982804084 | Keith Evans | Physical Therapy Assistant | 4001 Capitol Mall Dr Sw, Olympia, WA 98502-8657 | 2007-07-18 |
| Street Address |
1140 W 500 S |
| City | VERNAL |
| State | UT |
| Zip Code | 84078-2914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891157301 | Shellie Anderson | Counselor | 1140 W 500 S, Vernal, UT 84078-2914 | 2016-03-23 |
| 1225429103 | Stephanie Lee Odriscoll | Case Manager/Care Coordinator | 1140 W 500 S, Vernal, UT 84078-2914 | 2015-02-12 |
| 1740698174 | Melissa Slaugh | Registered Nurse | 1140 W 500 S, Vernal, UT 84078-2914 | 2014-07-29 |
| 1932464690 | Sheila Wallace | Case Manager/Care Coordinator | 1140 W 500 S, Vernal, UT 84078-2914 | 2012-07-09 |
| 1992098602 | Catherine Patricia Jurado | Counselor | 1140 W 500 S, Vernal, UT 84078-2914 | 2011-05-27 |
| 1033416797 | Frances Barnett Lewis | Counselor | 1140 W 500 S, Vernal, UT 84078-2914 | 2011-02-16 |
| 1093019960 | Amy Lynne Wilson | Case Manager/Care Coordinator | 1140 W 500 S, Vernal, UT 84078-2914 | 2011-01-06 |
| 1467691170 | Donita J Fulton | Registered Nurse | 1140 W 500 S, Vernal, UT 84078-2914 | 2009-02-19 |
| 1033358650 | Brandie A Mitchell | Licensed Practical Nurse | 1140 W 500 S, Vernal, UT 84078-2914 | 2009-02-05 |
| 1104077825 | Heather Coonradt | Case Manager/Care Coordinator | 1140 W 500 S, Vernal, UT 84078-2914 | 2008-10-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205479748 | Wade Oliver Moulton | Pharmacist | 1080 W Hwy 40, Vernal, UT 84078 | 2019-10-28 |
| 1841610383 | Allegiance Addiction Recovery Center | Substance Abuse Rehabilitation Facility | 4430 N Little Valley Road, Vernal, UT 84078 | 2014-04-23 |
| 1689008773 | Ashley Valley Physician Practice, LLC | Occupational Therapist | 1680 W Highway 40 Ste 202, Vernal, UT 84078 | 2013-08-26 |
| 1528371796 | Terry L Smith | Counselor | 1140 W 500 S #9, Vernal, UT 84078 | 2010-07-16 |
| 1619280880 | Cicile M Rios | Counselor | 1140 W 800 S #9, Vernal, UT 84078 | 2010-07-16 |
| 1265754840 | Marjorie Elaine Gardner | Licensed Practical Nurse | 133 S 500 East, Vernal, UT 84078 | 2010-02-23 |
| 1528205853 | Robert Kirkham Jolley | Dentist | 40 West 100 North, Vernal, UT 84078 | 2009-01-08 |
| 1740482025 | Ashley Valley Physician Practice, LLC | Family Medicine | 175 N. 100 W., Suite 202, Vernal, UT 84078 | 2007-05-31 |
| 1265646459 | Ashley Valley Medical Center | Pharmacy | 151 W. 200 N., Vernal, UT 84078 | 2007-05-09 |
| 1629122692 | Brian Prentice Callahan | Dentist | 779 West Us Highway 40, Vernal, UT 84078 | 2007-01-23 |
| Find all providers in zip 84078 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396393369 | Root Medical | General Practice | 266 W 100 N Ste 2, Vernal, UT 84078-2026 | 2019-09-03 |
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| 1154973576 | Koraima Morel Tirado | General Practice | 1035 W 190 S, Lehi, UT 84043-3833 | 2019-07-15 |
| 1841856986 | Northwestern Band of The Shoshone Nation Health & Human Services Dept. | General Practice | 241 W Forest St Ste A, Brigham City, UT 84302-2014 | 2019-05-14 |
| 1790297661 | The Bridge Recovery Center | General Practice | 98 N 6680 W, Hurricane, UT 84737-6138 | 2017-10-31 |
| 1790295947 | Low T Clinic, LLC | General Practice | 2150 N Main St Ste 10, North Logan, UT 84341-1740 | 2017-10-02 |
| 1104345636 | Coral Canyon Joint & Spine Health | General Practice | 83 S 2600 W Ste 102, Hurricane, UT 84737-3268 | 2017-09-15 |
| 1255795134 | Pain Management Professionals LLC | General Practice | 4541 S 700 E, Suite 100, Murray, UT 84107-4118 | 2016-04-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.