KEVIN DALE NEWBOLD (NPI# 1366917577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366917577 |
| Entity Type | Individual |
| Full Name | KEVIN DALE NEWBOLD |
| Practice Address |
3895 Harrison Blvd Ogden UT 84403-2312 |
| Mailing Address |
36 S State St Salt Lake City UT 84111-1401 |
| Practice Telephone | 8013877678 |
| Practice Fax Number | 8013878538 |
| Mailing Telephone | 8014422000 |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2018-10-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
8984745-4405 | UT | Allopathic & Osteopathic Physicians |
| N | 363L00000X | Nurse Practitioner | 8984745-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
8984745-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
8984745-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 163WR0006X |
Registered Nurse Specialization: Registered Nurse First Assistant |
8984745-4405 | UT | Nursing Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 201 W Layton Pkwy, Layton, UT 840413692 | 8013877678 | 8013878538 |
| Street Address |
3895 HARRISON BLVD |
| City | OGDEN |
| State | UT |
| Zip Code | 84403-2312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346420882 | Mckay Dee Surgical Center LLC | Clinic/Center | 3895 Harrison Blvd, Ogden, UT 84403-2312 | 2007-11-13 |
| 1972157576 | Tyson Jorgensen | Physical Therapist | 3895 Harrison Blvd, Ogden, UT 84403-2312 | 2019-07-31 |
| 1417410309 | Shane Edwin Hancock | Pharmacist | 3895 Harrison Blvd, C/o 1st Floor Pharmacy, Ogden, UT 84403-8440 | 2019-04-09 |
| 1184117475 | Laila Gerace | Physical Therapist | 3895 Harrison Blvd, Ogden, UT 84403-2312 | 2018-06-11 |
| 1740711464 | Summer Yack | Physical Therapy Assistant | 3895 Harrison Blvd, Ogden, UT 84403-2312 | 2017-03-23 |
| 1922543495 | Michelle Dawson | Specialist/Technologist | 3895 Harrison Blvd, Ogden, UT 84403-2311 | 2016-12-19 |
| 1215479555 | Justin Vernon Burr | Physical Therapist | 3895 Harrison Blvd, Ogden, UT 84403-2311 | 2016-11-16 |
| 1336692516 | Ihc Health Services Inc | Pharmacy | 3895 Harrison Blvd, Ogden, UT 84403-2312 | 2016-07-25 |
| 1043697154 | Ihc Health Services Inc | Orthopaedic Surgery | 3895 Harrison Blvd, Ogden, UT 84403-8440 | 2015-04-28 |
| 1619362480 | Justin Michael Johnson | Physician Assistant | 3895 Harrison Blvd, Ogden, UT 84403-2312 | 2015-03-30 |
| Find all providers in the same location | ||||
| 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 | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306473368 | Stephanie Michaele Turner | Nurse Practitioner | 865 Maple St, Ogden, UT 84403-1923 | 2020-03-26 |
| 1114579596 | James Edward Fenton Jr. | Nurse Practitioner | 2351 Grant Ave Ste 201, Ogden, UT 84401 | 2019-07-15 |
| 1891205811 | Amy Lynn Hinckley | Nurse Practitioner | 4933 S 1500 W Ste 200, Ogden, UT 84405-7738 | 2017-10-04 |
| 1619426376 | Angela Weil | Nurse Practitioner | 2540 Washington Blvd Ste 122, Ogden, UT 84401-3112 | 2016-09-22 |
| 1235531500 | Tyson Oakey | Nurse Practitioner | 3860 Jackson Ave Ste 7, Ogden, UT 84403-1979 | 2014-09-18 |
| 1144668591 | Jordan Wyler Johnsen | Nurse Practitioner | 4387 Harrison Blvd Ste D8, Ogden, UT 84403-3267 | 2013-06-07 |
| 1275979841 | Dustin C Jasmer | Nurse Practitioner | 5315 S 500 E Ste A, Ogden, UT 84405-4772 | 2013-05-22 |
| 1740585603 | Angela Lynn Christner | Nurse Practitioner | 245 W Walnut St, Ogden, IA 50212-7705 | 2011-01-24 |
| 1558512897 | Trent Willey | Nurse Practitioner | 1447 Canyon Cove Gln Apt 29, Ogden, UT 84401-0829 | 2008-10-06 |
| 1770747941 | Mary Leslie Rohan | Nurse Practitioner | 1128 University Cir, Student Service Center 190, Ogden, UT 84408-1128 | 2008-07-16 |
| 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.