MICHAEL K NEILSON (NPI# 1306378823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306378823 |
| Entity Type | Individual |
| Full Name | MICHAEL K NEILSON |
| Credential | D.O. |
| Practice Address |
475 W 940 N Provo UT 84604-3301 |
| Mailing Address |
Po Box 27128 Salt Lake City UT 84127-0128 |
| Practice Telephone | 8013577871 |
| Mailing Telephone | 8013577871 |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2020-07-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 11680858-1204 | UT | Allopathic & Osteopathic Physicians |
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
11680858-1204 | UT | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811946841 | Michael Gene Neilson | Dentist | 60th Dental Squadron, 101 Bodin Circle, Travis Afb, CA 94535 | 2006-05-08 |
| 1215457064 | Michael Neilson | Student in an Organized Health Care Education/Training Program | 984150 Nebraska Medical Ctr, Omaha, NE 68198-4150 | 2017-06-22 |
| 1386056752 | Michael N Neilson | Surgery | 35 Medical Center Pkwy, Augusta, ME 04330-8160 | 2014-05-20 |
| Street Address |
475 W 940 N |
| City | PROVO |
| State | UT |
| Zip Code | 84604-3301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760598411 | Nicole Anne Clark | Family Medicine | 475 W 940 N, Provo, UT 84604-3301 | 2006-08-22 |
| 1093343980 | Matias A Calquin | Student in an Organized Health Care Education/Training Program | 475 W 940 N, Provo, UT 84604-3301 | 2020-03-28 |
| 1740817535 | Sean Alton Kiesel | Student in an Organized Health Care Education/Training Program | 475 W 940 N, Provo, UT 84604-3301 | 2020-03-24 |
| 1760019699 | Cameron G Smith | Student in an Organized Health Care Education/Training Program | 475 W 940 N, Provo, UT 84604-3301 | 2020-03-23 |
| 1578199592 | Jessica Fullmer | Student in an Organized Health Care Education/Training Program | 475 W 940 N, Provo, UT 84604-3301 | 2020-03-21 |
| 1285260232 | Tessa Nell | Student in an Organized Health Care Education/Training Program | 475 W 940 N, Provo, UT 84604-3301 | 2020-03-20 |
| 1154957207 | Andrew Reid Smith | Student in an Organized Health Care Education/Training Program | 475 W 940 N, Provo, UT 84604-3301 | 2020-03-20 |
| 1922634971 | Brady Monte Hansen | Student in an Organized Health Care Education/Training Program | 475 W 940 N, Provo, UT 84604-3301 | 2020-03-20 |
| 1952861288 | Daniel Payne | Family Medicine | 475 W 940 N, Provo, UT 84604-3301 | 2019-03-22 |
| 1063971240 | Matthew Edwards Potter | Family Medicine | 475 W 940 N, Provo, UT 84604-3301 | 2019-03-18 |
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| 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 | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922232867 | Christopher R. Gordon | Family Medicine | 1157 N 300 W, Provo, UT 84604-6124 | 2009-05-06 |
| 1043486384 | Matthew Craig Evans | Family Medicine | 1157 N 300 W, #201, Provo, UT 84604-6124 | 2008-05-06 |
| 1740242973 | Karl N Weenig | Family Medicine | 1055 N 500 W, Suite 121, Provo, UT 84604-3305 | 2006-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053702431 | Weber State University | Family Medicine | 1001 University Cir, Ogden, UT 84408-5525 | 2015-02-06 |
| 1720169915 | Stuart Eliot Willick | Family Medicine | 1493 Lowell Ave, Park City, UT 84060 | 2006-10-17 |
| 1043210248 | Trek Lyons | Family Medicine | 1300 N 500 E, Suite 130, Logan, UT 84341-2408 | 2005-07-28 |
| 1316323165 | Dixie State University | Family Medicine | 225 S 700 E, St George, UT 84770-3875 | 2015-08-04 |
| 1285013987 | Sportsmed Associates LLC | Family Medicine | 3401 N Center St, Ste 100, Lehi, UT 84043-7497 | 2015-05-27 |
| 1164826665 | University of Utah Adult Services | Family Medicine | 555 Foothill Dr, Salt Lake City, UT 84112-1106 | 2014-10-14 |
| 1164860573 | Brett Wayne Martindale | Family Medicine | 4700 Harrison Blvd, Ogden, UT 84403-4303 | 2013-06-07 |
| 1053631069 | Tye Harrison | Family Medicine | 1350 N 500 E, Logan, UT 84341-2400 | 2010-06-02 |
| 1720303837 | Nicholas E Monson | Family Medicine | 2132 N 1700 W, 230, Layton, UT 84041-7057 | 2010-03-31 |
| 1346478476 | Ryan Albert Slater | Family Medicine | 1184 E 80 N, American Fork, UT 84003-2906 | 2009-06-26 |
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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.