KENT WILLIS (NPI# 1114306131) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114306131 |
| Entity Type | Individual |
| Full Name | KENT WILLIS |
| Credential | D.O. |
| Practice Address |
830 N 2000 W Pleasant Grove UT 84062 |
| Mailing Address |
830 N 2000 W Pleasant Grove UT 84062-4047 |
| Practice Telephone | 8017563511 |
| Mailing Telephone | 8017563511 |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2018-07-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 10701125-1204 | UT | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 10701125-1204 | UT | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3291 Loma Vista Rd, Ventura, CA 930033099 | 8056526100 | 8056523252 |
| 5505 S 900 E Ste 240, Murray, UT 841177210 | 8017835011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528300431 | Kent Avery Willis | Pediatrics | 853 Jefferson Ave Rm 201, Memphis, TN 38103-2807 | 2013-03-19 |
| Street Address |
830 N 2000 W |
| City | PLEASANT GROVE |
| State | UT |
| Zip Code | 84062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235138751 | Sean Cameron Doyle | Family Medicine | 830 N 2000 W, Pleasant Grove, UT 84062-4047 | 2005-07-18 |
| 1154805596 | Monica Constanza Bruna | Nurse Practitioner | 830 N 2000 W, Pleasant Grove, UT 84062-4047 | 2018-09-21 |
| 1306322441 | Emanita Christable Mounga | Licensed Practical Nurse | 830 N 2000 W, Pleasant Grove, UT 84062-4047 | 2018-07-12 |
| 1598274987 | Sheri Lynn Casey | Physician Assistant | 830 N 2000 W, Pleasant Grove, UT 84062 | 2017-09-28 |
| 1750786190 | Camber M Hess | Nurse Practitioner | 830 N 2000 W, Pleasant Grove, UT 84062-4047 | 2014-10-28 |
| 1619388998 | William R Francis Jr. | Family Medicine | 830 N 2000 W, Pleasant Grove, UT 84062-4047 | 2014-05-08 |
| 1750725735 | Premier Family Medical | Family Medicine | 830 N 2000 W, Pleasant Grove, UT 84062 | 2013-04-22 |
| 1497044911 | Michael Douglas Lehnardt | Family Medicine | 830 N 2000 W, Pleasant Grove, UT 84062-4047 | 2011-04-05 |
| 1043466899 | Jill Bergeson Barkdull | Family Medicine | 830 N 2000 W, Pleasant Grove, UT 84062-4047 | 2008-08-12 |
| 1184787566 | Ruth A Hooper | Nurse Practitioner | 830 N 2000 W, Pleasant Grove, UT 84062-4047 | 2006-12-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467934406 | Welcome Home Assisted Living of American Fork | Assisted Living Facility | 1889 W 930 N, Pleasant Grove, UT 84062 | 2018-09-06 |
| 1497243414 | Doterra Employee Health Systems, LLC | Family Medicine | 1364 Pleasant Grove Blvd., Floor 3, Pleasant Grove, UT 84062 | 2018-04-25 |
| 1720588080 | Us Sports Medicine, LLC | Clinic/Center | 1982 W. Pleasant Grove Blvd, Suite L, Pleasant Grove, UT 84062 | 2018-02-13 |
| 1235669011 | Rapid Reboot Recovery Products LLC | Durable Medical Equipment & Medical Supplies | 1262 W 3150 N, Pleasant Grove, UT 84062 | 2017-06-14 |
| 1497126486 | Trumobility Inc. | Durable Medical Equipment & Medical Supplies | 272 S 671 W, Pleasant Grove, UT 84062 | 2015-10-15 |
| 1295146272 | North County Medical | Chiropractor | 1988 West 930 North Suite Number A, Pleasant Grove, UT 84062 | 2014-05-13 |
| 1861814493 | Trent Edwards | Case Manager/Care Coordinator | 365 West 1420 North, Pleasant Grove, UT 84062 | 2014-01-16 |
| 1013342690 | Michael M. Haderlie | Psychologist | 233 S. Pleasant Grove Blvd, Suite 203, Pleasant Grove, UT 84062 | 2013-09-13 |
| 1194157123 | Brianna Lastre | Nurse Practitioner | 1446 W Pleasant Grove Blvd., Pleasant Grove, UT 84062 | 2013-08-01 |
| 1356619266 | Melinda Buchanan-emery | Marriage & Family Therapist | 459 East 1000 South, Pleasant Grove, UT 84062 | 2011-12-06 |
| Find all providers in zip 84062 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497243414 | Doterra Employee Health Systems, LLC | Family Medicine | 1364 Pleasant Grove Blvd., Floor 3, Pleasant Grove, UT 84062 | 2018-04-25 |
| 1619411774 | Brighterlife Family Wellness Center, Pllc | Family Medicine | 471 E 1000 S, Ste E, Pleasant Grove, UT 84062-3693 | 2016-12-08 |
| 1255324984 | Brannick Barton Riggs | Family Medicine | 360 S 1300 W, Pleasant Grove, UT 84062-3761 | 2005-08-29 |
| 1235138751 | Sean Cameron Doyle | Family Medicine | 830 N 2000 W, Pleasant Grove, UT 84062-4047 | 2005-07-18 |
| 1851921993 | Aspen Consolidated Health LLC | Family Medicine | 360 S 1300 W, Pleasant Grove, UT 84062-3761 | 2020-01-16 |
| 1962879940 | In2it Medical LLC | Family Medicine | 1888 W 800 N, Pleasant Grove, UT 84062-4097 | 2015-08-26 |
| 1619388998 | William R Francis Jr. | Family Medicine | 830 N 2000 W, Pleasant Grove, UT 84062-4047 | 2014-05-08 |
| 1750725735 | Premier Family Medical | Family Medicine | 830 N 2000 W, Pleasant Grove, UT 84062 | 2013-04-22 |
| 1497044911 | Michael Douglas Lehnardt | Family Medicine | 830 N 2000 W, Pleasant Grove, UT 84062-4047 | 2011-04-05 |
| 1043466899 | Jill Bergeson Barkdull | Family Medicine | 830 N 2000 W, Pleasant Grove, UT 84062-4047 | 2008-08-12 |
| Find all providers in PLEASANT GROVE | ||||
| City | PLEASANT GROVE |
| Zip Code | 84062 |
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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.