JACOB LAMAR PUGH (NPI# 1396227146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396227146 |
| Entity Type | Individual |
| Full Name | JACOB LAMAR PUGH |
| Credential | PA |
| Practice Address |
5640 S 3500 W Roy UT 84067-9158 |
| Mailing Address |
1055 North 500 West Attn: Credentialing Prov UT 84604-3305 |
| Practice Telephone | 8017732838 |
| Practice Fax Number | 8017733025 |
| Mailing Telephone | 8013548225 |
| Mailing Fax Number | 8014180941 |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2020-03-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 10959210-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174000673 | Jacob Charles Pugh | Pharmacist | 6615 Roswell Rd, Sandy Springs, GA 30328-3190 | 2018-07-26 |
| Street Address |
5640 S 3500 W |
| City | ROY |
| State | UT |
| Zip Code | 84067-9158 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255398921 | Jeffery W Anderson | Physician Assistant | 5640 S 3500 W, Roy, UT 84067-9158 | 2006-04-27 |
| 1801448790 | Traci Michelle Allison | Nurse Practitioner | 5640 S 3500 W, Roy, UT 84067 | 2019-07-11 |
| 1699261081 | Joni Michelle Jones | Nurse Practitioner | 5640 S 3500 W, Roy, UT 84067-9158 | 2018-07-09 |
| 1144584228 | Jerrica Elizabeth Stoddard | Nurse Practitioner | 5640 S 3500 W, Roy, UT 84067-9158 | 2012-07-03 |
| 1376853036 | Micheal Shawn Dawson | Physician Assistant | 5640 S 3500 W, Roy, UT 84067-9158 | 2010-10-15 |
| 1376744433 | Darlene L Petersen | Family Medicine | 5640 S 3500 W, Roy, UT 84067-9158 | 2007-05-29 |
| 1396814778 | Lucius Nmn Gordon Jr. | Physician Assistant | 5640 S 3500 W, Roy, UT 84067-9158 | 2006-11-07 |
| 1972536001 | Shiloh C Manning | Nurse Practitioner | 5640 S 3500 W, Roy, UT 84067-9158 | 2006-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881218220 | Breen Family Medicine, Pllc | Nurse Practitioner | 5991 S 3500 N, Roy, UT 84067 | 2020-06-01 |
| 1902349657 | Kelson Physician Partner's of Layton, Inc. | Pediatrics | 5286 S. 3500 W., Suite A, Roy, UT 84067 | 2016-11-29 |
| 1609258433 | Daniel Neumann | Pediatrics | 5682 S 3500 W, Roy, UT 84067 | 2015-06-29 |
| 1659641868 | Kelson Physijcian Partners of Layton, Inc | Pediatrics | 4040 South Midland Dr, Suite 2, Roy, UT 84067 | 2012-01-04 |
| 1346542834 | Midland Dental | Dentist | 4040 South Midland Drive, Suite 1, Roy, UT 84067 | 2010-12-03 |
| 1437398427 | Earl M. Cammack Jr. | Counselor | 4484 So. 1900 West, Suite 6, Roy, UT 84067 | 2009-02-13 |
| 1609086495 | Kelson Physician Partners of Layton, Inc. | Pediatrics | 5991 South 3500 West, Suite 100, Roy, UT 84067 | 2007-05-23 |
| 1396832655 | Standard Optical Co | Optometrist | 5421 S 19th W, Roy, UT 84067 | 2006-10-06 |
| 1457452864 | Paul D Hopkins Dds PC | Dentist | 4902 S 1900 W Suite 2, Roy, UT 84067 | 2006-09-26 |
| 1710085261 | Thomas R Austad | Podiatrist | 1885 West 4400 South, Roy, UT 84067 | 2006-09-20 |
| Find all providers in zip 84067 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841270907 | James E Parker | Physician Assistant | 3485 W 5200 So, Roy, UT 84067-9438 | 2006-01-17 |
| 1376853036 | Micheal Shawn Dawson | Physician Assistant | 5640 S 3500 W, Roy, UT 84067-9158 | 2010-10-15 |
| 1285797357 | Alisa Barnes | Physician Assistant | 5991 S 3500 W, Roy, UT 84067 | 2006-12-19 |
| 1396814778 | Lucius Nmn Gordon Jr. | Physician Assistant | 5640 S 3500 W, Roy, UT 84067-9158 | 2006-11-07 |
| 1184647786 | Richard R Russell | Physician Assistant | 1915 W 5950 S, Roy, UT 84067-1454 | 2006-07-25 |
| 1114915170 | Rodney K Grogan | Physician Assistant | 3485 W 5200 S, Roy, UT 84067-9438 | 2005-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417556986 | Brittany Tran | Physician Assistant | 2733 W Redwick Ct, Salt Lake City, UT 84129-5901 | 2020-10-25 |
| 1164020830 | Abbey Coburn | Physician Assistant | 6028 S Ridgeline Dr Ste 200, Ogden, UT 84405-6906 | 2020-10-14 |
| 1528674975 | James Christopher Nichols | Physician Assistant | 1746 E 2100 S, Salt Lake City, UT 84106-4165 | 2020-09-21 |
| 1164049201 | Makenzie Bishop | Physician Assistant | 1077 S 810 E, Provo, UT 84606-6390 | 2020-07-05 |
| 1700403995 | Amber Astle | Physician Assistant | 782 Canterbury Ln, Alpine, UT 84004-1255 | 2020-07-03 |
| 1306462304 | Carson Homer | Physician Assistant | 1715 S 40 W, Orem, UT 84058-8409 | 2020-06-25 |
| 1518583566 | Alexanders Fitness Company LLC | Physician Assistant | 245 S 1060 W, Lindon, UT 84042-1606 | 2020-06-24 |
| 1144844218 | Rebecca E Escoto | Physician Assistant | 3064 Creek Rd, Park City, UT 84098-4843 | 2020-06-03 |
| 1841826971 | David Souza | Physician Assistant | 52 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-03-20 |
| 1134751902 | Jacie Anna Mundahl | Physician Assistant | 8th Ave C St E 80, Salt Lake City, UT 84143-0001 | 2020-02-10 |
| Find all providers with the same taxonomy | ||||
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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.