BLUE CREEK MEDICAL (NPI# 1285279091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285279091 |
| Entity Type | Organization |
| Organization Name | BLUE CREEK MEDICAL |
| Practice Address |
9825 N 10800 W Tremonton UT 84337-9222 |
| Practice Telephone | 8888513677 |
| Practice Fax Number | 8888513671 |
| Mailing Telephone | 8888513677 |
| Mailing Fax Number | 8888513671 |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2019-11-15 |
| Authorized Official Name | AISHA BAILEY (BILLING DIRECTOR) |
| Authorized Official Telephone | 8888513677 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
Allopathic & Osteopathic Physicians |
| Street Address |
9825 N 10800 W |
| City | TREMONTON |
| State | UT |
| Zip Code | 84337-9222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568952190 | Bear River Valley Medical LLC | Clinic/Center | 9825 N 10800 W, Tremonton, UT 84337-9222 | 2018-05-18 |
| 1235777046 | Morgan Farnsworth | Technician/Technologist | 9825 N 10800 W, Tremonton, UT 84337-9222 | 2019-12-12 |
| 1790321404 | Samantha Brant | Psychiatry & Neurology | 9825 N 10800 W, Tremonton, UT 84337-9222 | 2019-11-18 |
| 1346894771 | Schyler Namanny | Technician/Technologist | 9825 N 10800 W, Tremonton, UT 84337-9222 | 2019-07-24 |
| 1447718754 | Anthony Farlaino | Technician/Technologist | 9825 N 10800 W, Tremonton, UT 84337-9222 | 2019-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134563760 | Jm Gauruder LLC | Chiropractor | 805 W Main St., Suite C, Tremonton, UT 84337 | 2013-04-25 |
| 1366717159 | Sean C Horsley | Social Worker | 905 N 1000 E, Tremonton, UT 84337 | 2012-03-13 |
| 1740420835 | Clifton Duane Kerr | General Practice | 725 West 1000 North, Tremonton, UT 84337 | 2009-03-02 |
| 1780877191 | Todd Miller | Family Medicine | 935 S 1000 W, Tremonton, UT 84337 | 2007-08-20 |
| 1982754081 | Bronson C Schultz | Dentist | 525 N 400 W, Tremonton, UT 84337 | 2007-01-11 |
| 1508423252 | Jeffrey David Zilles | Optometrist | 495 W 600 N, Tremonton, UT 84337 | 2019-05-28 |
| 1366828642 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 440 W Main St, Tremonton, UT 84337 | 2015-08-10 |
| 1720330228 | Kristina C Gerlach | Social Worker | 440 W 600 N, Tremonton, UT 84337 | 2012-10-08 |
| 1295818664 | Dee Duncan | Psychologist | 881 N Tremont St, Tremonton, UT 84337-1025 | 2006-10-21 |
| 1730558792 | Sarah Hurst | Specialist/Technologist | 720 N 350 E, Tremonton, UT 84337-1040 | 2015-09-21 |
| Find all providers in zip 84337 | ||||
| Taxonomy Code | 2084N0600X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Clinical Neurophysiology |
| Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285867275 | Hansann & Associates | Psychiatry & Neurology | 1470 S 500 E, Kaysville, UT 84037-3033 | 2009-08-25 |
| 1871679787 | Kevin Scott Mochizuki | Psychiatry & Neurology | 428 S Douglas St Apt 1, Salt Lake City, UT 84102 | 2006-10-31 |
| 1619965944 | Navin K Varma | Psychiatry & Neurology | 1452 E Ridgeline Dr #151, Ogden, UT 84405-4975 | 2005-10-11 |
| 1093710188 | Stephen Peters | Psychiatry & Neurology | 1157 N 300 W, Provo, UT 84604-6124 | 2005-06-16 |
| 1508098906 | Timber Ridge Holdings LLC | Psychiatry & Neurology | 448 E 5350 S Ste B, Washington Terrace, UT 84405-5415 | 2009-08-18 |
| 1891802591 | Tawnya M. Constantino | Psychiatry & Neurology | 5171 Cottonwood St, Suite 810, Murray, UT 84107-5704 | 2006-08-25 |
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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.