MICHELLE ANN SESTAK (NPI# 1508175563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508175563 |
| Entity Type | Individual |
| Full Name | MICHELLE ANN SESTAK |
| Credential | PA-C |
| Practice Address |
1756 Park Ave Riverton UT 84065-4701 |
| Practice Telephone | 8012540309 |
| Practice Fax Number | 8012541012 |
| Mailing Telephone | 8012540309 |
| Mailing Fax Number | 8012541012 |
| Enumeration Date | 2010-09-24 |
| Last Update Date | 2019-09-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
5707622-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
5707622-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1756 PARK AVE |
| City | RIVERTON |
| State | UT |
| Zip Code | 84065-4701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508853557 | Rebecca Jenson | Nurse Practitioner | 1756 Park Ave, Riverton, UT 84065-4701 | 2005-10-04 |
| 1932285186 | Riverton Family Health Center LLC | Clinic/Center | 1756 Park Ave, Riverton, UT 84065-4701 | 2006-10-31 |
| 1831186717 | Daniel Owen Thompson | Family Medicine | 1756 Park Ave, Riverton, UT 84065-4701 | 2005-10-05 |
| 1528055431 | Riverton Family Health Center LLC | Family Medicine | 1756 Park Ave, Riverton, UT 84065-4701 | 2005-10-05 |
| 1174510044 | Don Preston Allred | Family Medicine | 1756 Park Ave, Riverton, UT 84065-4701 | 2005-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972248 | William Lance Andersen | Pharmacist | 1202 W 12600 W, Riverton, UT 84065 | 2020-11-02 |
| 1275172678 | Dentists of Riverton, LLP | Dentist | 4531 W. Partridgehill Lane, Suite F-110, Riverton, UT 84065 | 2020-01-02 |
| 1194201467 | Patrick Kunkel | Dentist | 12569 2700 W, #100, Riverton, UT 84065 | 2018-07-19 |
| 1790274546 | Harmon City Inc | Pharmacy | 13330 South Kestrel Range Road, Riverton, UT 84065 | 2018-05-08 |
| 1386147767 | Richard Hayes Johnston | Counselor | 3740 S Market Center Dr #1200, Riverton, UT 84065 | 2018-03-13 |
| 1023537156 | Brenda Fuell | Dental Hygienist | 12959 South Picket Fence Lane, Riverton, UT 84065 | 2017-09-09 |
| 1407373426 | Bethany Marie Breck | Counselor | 3740 S Market Center Drive, #1200, Riverton, UT 84065 | 2017-08-30 |
| 1952848509 | Renaissance Ranch Bluffdale Women's Program | Substance Abuse Rehabilitation Facility | 2356 Thunderhead Way, Bluffdale, UT 84065 | 2017-01-20 |
| 1053856229 | Bradford Scott Bentley Jr. | Physical Therapist | 3741 W 12600 S, Ste 100, Riverton, UT 84065 | 2016-12-27 |
| 1194273524 | New Horizon | Preferred Provider Organization | 1420 W 12600 Sputh, Draper, UT 84065 | 2016-09-14 |
| Find all providers in zip 84065 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649892829 | Van Martin Stonehocker | Physician Assistant | 755 W Center St, Orem, UT 84057-5365 | 2020-05-11 |
| 1366004517 | Brock Bodily | Physician Assistant | 10623 S Redwood Rd # 101, South Jordan, UT 84095-2481 | 2019-07-08 |
| 1891230041 | Sarah Danielle Mendenhall | Physician Assistant | 5169 S Cottonwood St Ste 600, Murray, UT 84107-6771 | 2016-12-26 |
| 1104284124 | Amanda Cummings | Physician Assistant | 30 N 1900 E # 3b110, Salt Lake City, UT 84132-0002 | 2016-02-04 |
| 1043699101 | Chris Anderson | Physician Assistant | 30 North 1900 East #3c344, Salt Lake City, UT 84132 | 2015-05-22 |
| 1861895344 | Ariel Black | Physician Assistant | 30 N 1900 E # 3c344, Salt Lake City, UT 84132-0002 | 2014-09-29 |
| 1336493709 | Monica L Hatch | Physician Assistant | 2132 N 1700 W Ste 200, Layton, UT 84041-7060 | 2012-11-06 |
| 1912130311 | Andrew M Strong | Physician Assistant | 5323 Woodrow St Ste 202, Salt Lake City, UT 84107-5848 | 2009-09-01 |
| 1164666061 | Stephen A Loper | Physician Assistant | 1055 N 500 W Ste 211, Provo, UT 84604-3305 | 2009-04-23 |
| 1982869210 | Scott D Taylor | Physician Assistant | 5323 Woodrow St Ste 102, Murray, UT 84107-5853 | 2008-07-25 |
| 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.