LANDON DERU (NPI# 1346511532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346511532 |
| Entity Type | Individual |
| Full Name | LANDON DERU |
| Credential | ATC-L |
| Practice Address |
3730 Brinker Ave Ogden UT 84403-2019 |
| Practice Telephone | 8019283213 |
| Mailing Telephone | 8019283213 |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2012-01-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| 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 |
3730 BRINKER AVE |
| City | OGDEN |
| State | UT |
| Zip Code | 84403-2019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235744632 | Megan Louise Larkins | Specialist/Technologist | 4000 Brinker Ave. The Apartments., Apartment 15, Ogden, UT 84403 | 2020-09-11 |
| 1154959062 | Joshua Clifford Hansen | Student in an Organized Health Care Education/Training Program | 4403 Harrison Boulevard, Ste A700, Ogden, UT 84403 | 2020-03-28 |
| 1346895935 | Positional Release Therapy Institute LLC | Specialist/Technologist | 1702 E. 5600 S., Ogden, UT 84403 | 2019-08-09 |
| 1841842077 | Braken Wooden | Chiropractor | 1893 Skyline Dr., Suite 204, South Ogden, UT 84403 | 2019-07-09 |
| 1023670569 | Wasatch Advanced Dental Care LLC | Dentist | 3590 Harrison Blvd Suite #1, Ogden, UT 84403 | 2019-07-05 |
| 1194237636 | Marci Niemeyer | Physician Assistant | 5929 Fashion Point Dr Ste 101, South Ogden, UT 84403 | 2017-10-24 |
| 1578081949 | Stephanie Jensen | Specialist/Technologist | 1473 36th Street, Ogden, UT 84403 | 2017-09-06 |
| 1891213385 | Forrest Sutherland | Specialist/Technologist | 1075 E 41st St., Ogden, UT 84403 | 2017-09-05 |
| 1184159022 | Nicole Lee Van Tassell | In Home Supportive Care | 1496 East 5600 South, Unit 6, Ogden, UT 84403 | 2017-04-28 |
| 1265889166 | Modern Dental Professionals Ut, PC | Dentist | 5974 S. Fashion Pointe Drive, Suite 210, South Ogden, UT 84403 | 2016-05-20 |
| Find all providers in zip 84403 | ||||
| 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 |
|---|---|---|---|---|
| 1689299737 | Joshua Jene Holloway | Student in an Organized Health Care Education/Training Program | 1563 27th St, Ogden, UT 84403-0410 | 2020-06-15 |
| 1639794860 | Colleen Degroot | Student in an Organized Health Care Education/Training Program | 1465 26th St, Ogden, UT 84401-2933 | 2020-06-12 |
| 1154959062 | Joshua Clifford Hansen | Student in an Organized Health Care Education/Training Program | 4403 Harrison Boulevard, Ste A700, Ogden, UT 84403 | 2020-03-28 |
| 1720631880 | Kelsey Askea | Student in an Organized Health Care Education/Training Program | 2261 Washington Blvd #102, Ogden, UT 84401 | 2019-07-18 |
| 1346797479 | Nehida Estevez | Student in an Organized Health Care Education/Training Program | 201 Wildcat Vlg, Ogden, UT 84408 | 2016-09-07 |
| 1063968741 | Robert J Reeve | Student in an Organized Health Care Education/Training Program | 4050 Taylor Ave, Ogden, UT 84403-2528 | 2016-08-31 |
| 1659774263 | Andrew Richards | Student in an Organized Health Care Education/Training Program | 490 W 24th St, Ogden, UT 84401-1223 | 2014-09-28 |
| 1316347172 | Alex Leonardi | Student in an Organized Health Care Education/Training Program | 1435 Village Drive, Dept. 2801, Ogden, UT 84408 | 2014-08-29 |
| 1811120223 | Lizbeth Velazquez | Student in an Organized Health Care Education/Training Program | 391 Madison Ave, Ogden, UT 84404-2423 | 2009-09-02 |
| 1346878139 | Monica Rodgers | Student in an Organized Health Care Education/Training Program | 4403 Harrison Blvd Ste 700a, Ogden, UT 84403-3295 | 2020-03-29 |
| Find all providers in OGDEN | ||||
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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.