MR. PHILLIP JAMES ADRIAN HARTOG (NPI# 1124542451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124542451 |
| Entity Type | Individual |
| Full Name | MR. PHILLIP JAMES ADRIAN HARTOG |
| Credential | ATC |
| Practice Address |
1143 Smith Fieldhouse Provo UT 84602 |
| Mailing Address |
1143 Smith Fieldhouse Provo UT 84602-2246 |
| Practice Telephone | (801) 422-4828 |
| Mailing Telephone | 8014224828 |
| Enumeration Date | 2017-07-28 |
| Last Update Date | 2017-07-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
9903810-4810 | UT | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1143 SMITH FIELDHOUSE |
| City | PROVO |
| State | UT |
| Zip Code | 84602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144847161 | Tara Marquez | Specialist/Technologist | Brigham Young University Sports Medicine 123 Sab, Provo, UT 84602 | 2020-06-26 |
| 1265071575 | Scott Daly Hosford | Psychologist | 2500 Wsc, Provo, UT 84602 | 2020-01-03 |
| 1417591728 | Christine Padilla | Specialist/Technologist | 331 Student Athlete Building, Provo, UT 84602 | 2019-10-30 |
| 1255999637 | Thomas Golightly | Psychologist | 1500 Wsc Byu, Provo, UT 84602 | 2019-05-31 |
| 1881179323 | David Inouye Takasaki | Specialist/Technologist | 331 Sab, Provo, UT 84602 | 2018-10-01 |
| 1568949006 | Mckenna Taylor | Specialist/Technologist | 1120 Sfh Brigham Young University, Provo, UT 84602 | 2018-07-27 |
| 1821513755 | Sarah Huppi | Physical Medicine & Rehabilitation | 1130 Sfh, Provo, UT 84602 | 2017-08-11 |
| 1427572627 | Mackenzie Booth | Physical Medicine & Rehabilitation | 1120 Sfh, Brigham Young University, Provo, UT 84602 | 2017-07-29 |
| 1114479698 | Christopher Jay Hortin | Specialist/Technologist | 106 Sfh, Provo, UT 84602 | 2016-10-31 |
| 1497154488 | Lindsay Voelkl | Specialist/Technologist | 150 East Bulldog Blvd, Provo, UT 84602 | 2014-08-15 |
| Find all providers in zip 84602 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144847161 | Tara Marquez | Specialist/Technologist | Brigham Young University Sports Medicine 123 Sab, Provo, UT 84602 | 2020-06-26 |
| 1053935551 | Olivia Stiles | Specialist/Technologist | 200 E 515 N, Provo, UT 84606 | 2020-06-01 |
| 1780210062 | Andrew Jacob Roush | Specialist/Technologist | 226 E 400 N, Provo, UT 84606-2914 | 2020-03-18 |
| 1578194577 | Veronica R Montes | Specialist/Technologist | 1060 E 450 N Apt 335, Provo, UT 84606-3433 | 2020-01-28 |
| 1417591728 | Christine Padilla | Specialist/Technologist | 331 Student Athlete Building, Provo, UT 84602 | 2019-10-30 |
| 1093356131 | Krystall Greenwell | Specialist/Technologist | 1130 Smith Field House, Brigham Young University, Provo, UT 84604-8460 | 2019-09-30 |
| 1174173710 | Kathleen Nichole Thiriot | Specialist/Technologist | 396 S 1350 E, Provo, UT 84606-5320 | 2019-09-16 |
| 1083270276 | Jessica Marie Wetsel | Specialist/Technologist | 761 W 600 S Apt 14, Provo, UT 84601-4125 | 2019-05-14 |
| 1558829911 | Devin Anderson | Specialist/Technologist | 123 Sab, Provo, UT 84602-1547 | 2019-03-05 |
| 1376016790 | Carolyn Billings | Specialist/Technologist | 1140 Smith Fieldhouse, Provo, UT 84602-2246 | 2019-01-08 |
| Find all providers in PROVO | ||||
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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.