KENT BLAD (NPI# 1336219906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336219906 |
| Entity Type | Individual |
| Full Name | KENT BLAD |
| Credential | FNP |
| Practice Address |
1675 N Freedom Blvd Bldg 3 Provo UT 84604-2540 |
| Practice Telephone | 8013778000 |
| Practice Fax Number | 8013778001 |
| Mailing Telephone | 8013778000 |
| Mailing Fax Number | 8013778001 |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2011-10-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
217117-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | D2731 | 05 |
| Street Address |
1675 N FREEDOM BLVD BLDG 3 |
| City | PROVO |
| State | UT |
| Zip Code | 84604-2540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912991738 | Northwest Orthotics & Prosthetics | Durable Medical Equipment & Medical Supplies | 1675 N Freedom Blvd, Ste 12 C, Provo, UT 84604-2540 | 2005-09-08 |
| 1942588082 | Keith J. Clayton, M.d., P.C. | Pediatrics | 1675 N Freedom Blvd, Ste 9c, Provo, UT 84604 | 2011-07-22 |
| 1851693808 | Russell James Bailey | Psychologist | 1675 N Freedom Blvd, Suite 2b2, Provo, UT 84604-2540 | 2010-11-24 |
| 1174778450 | Matthew Joseph Clayton | Pediatrics | 1675 N Freedom Blvd, Ste 9c, Provo, UT 84604-2540 | 2008-11-30 |
| 1932353539 | Now I Can Foundation | Clinic/Center | 1675 N Freedom Blvd, Suite 10b, Provo, UT 84604-2540 | 2008-11-10 |
| 1639321540 | Elizabeth Ann Jensen | Physical Therapist | 1675 N Freedom Blvd, Building 10b, Provo, UT 84604-2540 | 2008-10-22 |
| 1336364629 | Darren Wesley Gardner | Dentist | 1675 N Freedom Blvd, Ste 12a, Provo, UT 84604-2540 | 2007-04-13 |
| 1184847063 | New Horizon Women's Care, LLC | Internal Medicine | 1675 N Freedom Blvd, Suite 3, Provo, UT 84604-2540 | 2007-04-10 |
| 1194824201 | Provo Dialysis Center University of Utah | Clinic/Center | 1675 N Freedom Blvd, Provo, UT 84604-2540 | 2006-09-22 |
| 1265452163 | Damon Monson Faust | Chiropractor | 1675 N Freedom Blvd, 7a, Provo, UT 84604-2540 | 2006-07-20 |
| Find all providers in the same location | ||||
| 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 | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447505904 | Natalie Tollison | Nurse Practitioner | 1055 N 300 W Ste 300, Provo, UT 84604-3373 | 2012-07-19 |
| 1356676035 | Cherie Marie Farnes | Nurse Practitioner | 1355 N University Ave Ste 210, Provo, UT 84604-2721 | 2009-10-13 |
| 1891253456 | Laura Savage | Nurse Practitioner | 1055 N 300 W Ste 401, Provo, UT 84604-3306 | 2019-03-03 |
| 1477812691 | Marquelle Rogers | Nurse Practitioner | 1134 N 500 W, Suite #101, Provo, UT 84604-3383 | 2012-05-08 |
| 1013122548 | Michael Frank Gibson | Nurse Practitioner | 1355 North University Ave, Suite 210, Provo, UT 84604 | 2007-05-10 |
| 1851504393 | Sue Ann R Christensen | Nurse Practitioner | 1055 N 300 W, Suite 410, Provo, UT 84604-3344 | 2007-05-08 |
| 1548222706 | Amy Harmer Cox | Nurse Practitioner | 1055 N 300 W, Suite 311, Provo, UT 84604 | 2006-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841707569 | Deeann Cervantez | Nurse Practitioner | 100 N Mario Capecchi Dr Ste 3550, Salt Lake City, UT 84113-1103 | 2018-01-03 |
| 1962949586 | Gina Whitehead | Nurse Practitioner | 10 South 2000 East, Salt Lake City, UT 84112 | 2017-01-20 |
| 1417402389 | Heather Crockett Oram | Nurse Practitioner | 41 E 1140 N, Suite B, Saratoga Springs, UT 84045-5459 | 2016-08-22 |
| 1720452782 | Jane Garff Gardiner | Nurse Practitioner | 347 N Quince St, Salt Lake City, UT 84103-1641 | 2015-11-13 |
| 1992171185 | Angela Curtis Page | Nurse Practitioner | 484 E 1250 S, Kaysville, UT 84037-4005 | 2015-08-11 |
| 1982025961 | Teresa Steele | Nurse Practitioner | 5063 S Cottonwood St Ste, 160, Murray, UT 84107 | 2013-12-18 |
| 1578820858 | Helen Kathleen Aoki | Nurse Practitioner | 9071 S 1300 W Fl 3, West Jordan, UT 84088-6672 | 2012-04-11 |
| 1558505529 | Melissa Ann Neville-norton | Nurse Practitioner | 3875 Stadium Way # 3903 Weber State University, Ogden, UT 84408 | 2009-04-22 |
| 1306096920 | Molly Marie Andersen | Nurse Practitioner | 100 Mario Capecci Dr, Slc, UT 84113-1103 | 2008-09-19 |
| 1033383328 | Annette Smith Harman | Nurse Practitioner | 100 North Medical Dr., Slc, UT 84113 | 2008-04-17 |
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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.