CARLENE KAY BODEN (NPI# 1235128349) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235128349 |
| Entity Type | Individual |
| Full Name | CARLENE KAY BODEN |
| Credential | P.A. |
| Practice Address |
1152 E 200 N American Fork Hospital - Radiation Oncology American Fork UT 84003-2004 |
| Mailing Address |
Po Box 27128 Salt Lake City UT 84127-0128 |
| Practice Telephone | 8015358163 |
| Practice Fax Number | 8013554011 |
| Mailing Telephone | 8014421900 |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2016-10-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 103852 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| N | 103K00000X | Behavioral Analyst | BEVB12 | AK | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | MB1206383 | 01 |
| Street Address |
1152 E 200 N AMERICAN FORK HOSPITAL - RADIATION ONCOLOGY |
| City | AMERICAN FORK |
| State | UT |
| Zip Code | 84003-2004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669002150 | Jacob Aaron Barlow | Nurse Practitioner | 1152 E 200 N, American Fork, UT 84003-2004 | 2020-01-23 |
| 1710539234 | Emily Moody | Genetic Counselor, MS | 1152 E 200 N, American Fork, UT 84003-2004 | 2019-07-15 |
| 1891106936 | Nicholas Thomson | Internal Medicine | 1152 E 200 N, American Fork, UT 84003-2004 | 2014-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851917496 | Centre Health Group | Clinic/Center | 70 West Main, Suite B, American Fork, UT 84003 | 2020-06-19 |
| 1457902553 | Lactation Link | Health Educator | 5524 Sicily Lane, Highland, UT 84003 | 2019-09-20 |
| 1750805511 | Eric Austin Haws | Physical Therapist | 1184 East 80 North, American Fork, UT 84003 | 2017-08-02 |
| 1578914784 | Ofa Moeai | Social Worker | 315 N 900 E, American Fork, UT 84003 | 2016-06-29 |
| 1639585839 | Carmel Ferreira | Acupuncturist | 42 N 200 E Ste 1, American Fork, UT 84003 | 2014-07-08 |
| 1619305869 | Luke Daren Sterger | Counselor | 995 West 1100 North, American Fork, UT 84003 | 2013-10-25 |
| 1356778252 | Reese & Weaver Dds LLC | Optometrist | 11038 N. Highland Blvd, Suite 200, Highland, UT 84003 | 2013-10-09 |
| 1518308444 | A Balanced Life Med Products | Durable Medical Equipment & Medical Supplies | 291 N 300 E Ste. C, American Fork, UT 84003 | 2013-07-08 |
| 1376981274 | Jesse Lucinda James | Family Medicine | 98 B. 1100 E. Suite #102, American Fork, UT 84003 | 2013-06-13 |
| 1922442904 | Premier Family Medical | Family Medicine | 226 N 100 E, Ste A, American Fork, UT 84003 | 2013-04-22 |
| Find all providers in zip 84003 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306491782 | Wesley Robert Clegg | Physician Assistant | 1175 E 50 S # 211, American Fork, UT 84003-2845 | 2019-08-02 |
| 1669418455 | David T Waldron | Physician Assistant | 98 N 1100 E Ste 103, American Fork, UT 84003-2940 | 2006-06-21 |
| 1538713920 | Sabrina Cowan | Physician Assistant | 98 N 1100 E Ste 203, American Fork, UT 84003 | 2019-07-24 |
| 1457860934 | Christopher Jay Wilcox | Physician Assistant | 1184 E 80 N, American Fork, UT 84003-2906 | 2017-09-27 |
| 1477072015 | Brian Grier | Physician Assistant | 1184 E 80 N, American Fork, UT 84003-2906 | 2017-09-14 |
| 1891214540 | Joshua Vance | Physician Assistant | 1175 E 50 S Ste 211, American Fork, UT 84003-2845 | 2017-09-13 |
| 1851843353 | Sarah Anne Witesman | Physician Assistant | 1159 E 200 N Ste 250, American Fork, UT 84003-2028 | 2016-10-31 |
| 1295197614 | Doctors At Home With Dignity | Physician Assistant | 831 E 340 S Ste 230, American Fork, UT 84003-3493 | 2016-03-24 |
| 1811391121 | Danelle Schmutz | Physician Assistant | 1159 E 200 N Ste 250, American Fork, UT 84003-2028 | 2014-10-15 |
| 1467861849 | Tanya Bidstrup Przybyla | Physician Assistant | 226 N 1100 E, American Fork, UT 84003-2054 | 2014-08-11 |
| Find all providers in AMERICAN FORK | ||||
| City | AMERICAN FORK |
| Zip Code | 84003 |
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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.