DR. BROCK BAKER (NPI# 1306397849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306397849 |
| Entity Type | Individual |
| Full Name | DR. BROCK BAKER |
| Credential | M.D. |
| Practice Address |
5169 S Cottonwood St Murray UT 84107-6767 |
| Mailing Address |
5169 S Cottonwood St Suite 303 (building 2) Murray UT 84107-6767 |
| Practice Telephone | 8015073750 |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2016-10-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
5169 S COTTONWOOD ST |
| City | MURRAY |
| State | UT |
| Zip Code | 84107-6767 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518596501 | Jared John Thomsen | Student in an Organized Health Care Education/Training Program | 5169 S Cottonwood St, Murray, UT 84107-6767 | 2020-04-02 |
| 1063049518 | Gibson Arthur Edward Klapthor | Student in an Organized Health Care Education/Training Program | 5169 S Cottonwood St, Murray, UT 84107-6767 | 2020-03-25 |
| 1790232569 | Anne Clayton | Nurse Practitioner | 5169 S Cottonwood St, Murray, UT 84107-6767 | 2016-09-08 |
| 1346793940 | Jenna Kristine Robinson | Nurse Practitioner | 5169 S Cottonwood St, Ste 510, Murray, UT 84107-6767 | 2016-07-31 |
| 1518313121 | Ihc Health Services Inc | Internal Medicine | 5169 S Cottonwood St, Murray, UT 84107-6771 | 2016-05-12 |
| 1467819060 | Ihc Health Services | Physician Assistant | 5169 S Cottonwood St, Building 2, Suite 510, Murray, UT 84107-6767 | 2016-01-27 |
| 1851757892 | Catherine Nelson | Physician Assistant | 5169 S Cottonwood St, Building 2 Suite 510a, Murray, UT 84107-6767 | 2016-01-06 |
| 1407246135 | Teresa Sanders | Physician Assistant | 5169 S Cottonwood St, Suite 520, Murray, UT 84107 | 2015-02-03 |
| 1770900672 | Eric M Hu | Radiology | 5169 S Cottonwood St, Murray, UT 84107-6767 | 2014-03-28 |
| 1992133284 | Ihc Health Services Inc | Surgery | 5169 S Cottonwood St, Ste 400, Murray, UT 84107-6769 | 2013-10-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
| 1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
| 1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
| 1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
| 1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
| 1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
| 1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
| 1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
| 1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1396354585 | Esmeralda Ruby Barron | Student in an Organized Health Care Education/Training Program | 1344 E Merritt Cir, Murray, UT 84117-7327 | 2020-07-24 |
| 1669097705 | Tara Nidhi Acharya | Student in an Organized Health Care Education/Training Program | 3 E Hanauer Pl, Murray, UT 84107-3891 | 2020-06-15 |
| 1851916803 | Kenzie Harline Smith | Student in an Organized Health Care Education/Training Program | 1191 W Pitchfork Rd, Murray, UT 84123-7672 | 2020-06-15 |
| 1801415625 | Chase Jentry Mcclard | Student in an Organized Health Care Education/Training Program | 2120 Kelso Rd, Murray, KY 42071-4528 | 2020-04-12 |
| 1457970568 | Andrea Hayes | Student in an Organized Health Care Education/Training Program | 1107 Elm St, Murray, KY 42071-2345 | 2020-04-09 |
| 1457900680 | Matthew Edward Feinauer | Student in an Organized Health Care Education/Training Program | 6156 S Vinecrest Dr, Murray, UT 84121-1753 | 2019-09-10 |
| 1639721988 | William J. Fahrenbach | Student in an Organized Health Care Education/Training Program | 830 E 3990 S Apt B, Murray, UT 84107-2167 | 2019-07-16 |
| 1871045690 | Alex Coffman | Student in an Organized Health Care Education/Training Program | 5169 S Cottonwood St Ste 303, Murray, UT 84107-6768 | 2016-10-27 |
| 1245485499 | Chad Kent Christiansen | Student in an Organized Health Care Education/Training Program | 5169 Cottonwood St Ste 303, Murray, UT 84107-6768 | 2008-12-01 |
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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.