KINDRA K JACOBY (NPI# 1295925642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295925642 |
| Entity Type | Individual |
| Full Name | KINDRA K JACOBY |
| Credential | P.A. |
| Practice Address |
280 West River Park Dr. Ste. #350 Provo UT 84604 |
| Practice Telephone | 8012291014 |
| Practice Fax Number | 8012291067 |
| Mailing Telephone | 8012291014 |
| Mailing Fax Number | 8012291067 |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2007-07-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
4992594-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
280 WEST RIVER PARK DR. STE. #350 |
| City | PROVO |
| State | UT |
| Zip Code | 84604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
| Find all providers in zip 84604 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316240575 | James E Carly | Physician Assistant | 280 W Riverpark Dr Ste 120, Provo, UT 84604 | 2010-12-09 |
| 1851628218 | Robert Andrew Serpico | Physician Assistant | 1375 N University Ave, Provo, UT 84604-2658 | 2009-11-05 |
| 1588897524 | Alan Taylor Frampton | Physician Assistant | 1750 N Wymount Terrace Drive, Provo, UT 84602-4800 | 2009-08-25 |
| 1528271228 | Arnold Brett Davis | Physician Assistant | 1355 North University Ave, Suite 210, Provo, UT 84604 | 2007-05-08 |
| 1417977505 | Susan R Dyle | Physician Assistant | 619 N 500 W, Provo, UT 84601-1547 | 2006-07-20 |
| 1629035795 | Gary E Nelson | Physician Assistant | 150 E Center St, Suite 1100, Provo, UT 84606-3106 | 2006-05-01 |
| 1689142440 | Brian Todd Spencer | Physician Assistant | 1034 N 500 W, Provo, UT 84604-3380 | 2018-11-08 |
| 1003334525 | Kelly Marie Daly-wolfe | Physician Assistant | 589 S State St, Provo, UT 84606 | 2017-09-05 |
| 1982157301 | Rebekah Michelle Hosman | Physician Assistant | 3650 N University Ave, #200, Provo, UT 84604-6656 | 2016-08-02 |
| 1871960823 | Verdon Reed Walker IIi | Physician Assistant | 589 S State St, Provo, UT 84606-5056 | 2015-08-25 |
| 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.