MR. JAKE A KING (NPI# 1356658199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356658199 |
| Entity Type | Individual |
| Full Name | MR. JAKE A KING |
| Practice Address |
864 S Main St Ste 4 Brigham City UT 84302-3362 |
| Practice Telephone | 4357231799 |
| Mailing Telephone | 4357231799 |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2010-08-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 253J00000X | Foster Care Agency | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669881454 | Jake Slater King | Clinical Neuropsychologist | 950 E Haverford Rd Ste 305, Bryn Mawr, PA 19010-3851 | 2014-08-06 |
| Street Address |
864 S MAIN ST STE 4 |
| City | BRIGHAM CITY |
| State | UT |
| Zip Code | 84302-3362 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992012744 | Jade Hunsaker | Foster Care Agency | 864 S Main St Ste 4, Brigham City, UT 84302-3362 | 2010-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669945531 | Brandon Lee Allen | Counselor | 971 South 800 West, #104, Brigham City, UT 84302 | 2019-01-03 |
| 1104307495 | Tiffany Burnhope | Social Worker | 663 Parker Lane, Brigham City, UT 84302 | 2018-08-24 |
| 1558858464 | Michael Clark | Optometrist | 990 Medical Dr Ste G3, Brigham City, UT 84302 | 2018-04-16 |
| 1497273130 | Emily Marler | Counselor | 862 South Main Suite 4, Brigham City, UT 84302 | 2017-09-01 |
| 1003268731 | Tyler Beckstrand | Social Worker | 125 N Main Street, Brigham City, UT 84302 | 2016-07-06 |
| 1780030155 | Angela Stott | Case Manager/Care Coordinator | 160 E 800 S Apt. B216, Brigham City, UT 84302 | 2016-05-04 |
| 1699156802 | Christopher Jacobson | Family Medicine | 1050 Medical Dr, Brigham City, UT 84302 | 2015-06-12 |
| 1811377765 | Courtney Allred | Counselor | 863 S Main Street Suite 2, Brigham, UT 84302 | 2015-06-05 |
| 1235529579 | Belinda Castro | Counselor | 862 S Main Street Suite 2, Brigham City, UT 84302 | 2015-01-26 |
| 1760871818 | Ambryn Mccallson | Counselor | 862 S. Main, 4, Brigham City, UT 84302 | 2015-01-13 |
| Find all providers in zip 84302 | ||||
| Taxonomy Code | 253J00000X |
| Grouping | Agencies |
| Classification | Foster Care Agency |
| A Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as "24-hour substitute care for children outside their own homes." Foster care settings include, but are not limited to, nonrelative foster family homes, relative foster homes (whether payments are being made or not), group homes, emergency shelters, residential facilities, and pre-adoptive homes. |
| Notes: Source: Code Of Federal Regulations, Title 45, Volume 4, Part 1355, Section 57 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225449630 | Youthtrack, Inc | Foster Care Agency | 862 S Main Suite 4, Brigham City, UT 84302 | 2014-05-20 |
| 1093130130 | Brenda Tekell | Foster Care Agency | 862 S Main St Ste 201, Brigham City, UT 84302-3320 | 2014-02-26 |
| 1275879959 | Joshua Dallon | Foster Care Agency | 739 W 500 S, Brigham City, UT 84302-2820 | 2012-12-27 |
| 1902140841 | Scott Heninger | Foster Care Agency | 862 W Main St #4, Brigham City, UT 84302 | 2012-11-15 |
| 1972854909 | Melissa Fjeldsted | Foster Care Agency | 862 N Main St., Brigham City, UT 84302 | 2012-10-01 |
| 1417204330 | Daniel David Nelson | Foster Care Agency | 862 S Main St., #4, Brigham City, UT 84302-0887 | 2012-08-09 |
| 1598029639 | Jeremiah Hawkes Smith | Foster Care Agency | 682 S Main, Suite 4, Brigham City, UT 84302 | 2012-07-03 |
| 1346509098 | Ryan Geilmann | Foster Care Agency | 862 S Main St #4, Suite, Brigham City, UT 84302 | 2012-05-15 |
| 1275806143 | Stanley Blake Renda | Foster Care Agency | 862 S Main St Ste No4, Brigham City, UT 84302-3320 | 2012-02-22 |
| 1528352572 | Philip James Kraus | Foster Care Agency | 734 W 500 S, Brigham City, UT 84302-2821 | 2011-06-07 |
| Find all providers in BRIGHAM CITY | ||||
| City | BRIGHAM CITY |
| Zip Code | 84302 |
Please comment or provide details below to improve the information on MR. JAKE A KING.
| 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.