BERTRAM PRIDE (NPI# 1518593110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518593110 |
| Entity Type | Individual |
| Full Name | BERTRAM PRIDE |
| Practice Address |
1640 Redstone Center Dr Park City UT 84098-7605 |
| Mailing Address |
8931 Pardee Rd Taylor MI 48180-2741 |
| Practice Telephone | 2142649711 |
| Enumeration Date | 2020-03-16 |
| Last Update Date | 2020-03-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 4703111838 | MI | Nursing Service Providers |
| Street Address |
1640 REDSTONE CENTER DR |
| City | PARK CITY |
| State | UT |
| Zip Code | 84098-7605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255470779 | Sheetal Yogesh Jhaveri | Physical Therapist | 1640 Redstone Center Dr, Suite 200, Park City, UT 84098-7605 | 2007-02-05 |
| 1356988141 | Janet Mary Barmeier | Speech-Language Pathologist | 1640 Redstone Center Dr, Park City, UT 84098-7605 | 2019-11-29 |
| 1346806551 | Shabrittany Williams | Physical Therapy Assistant | 1640 Redstone Center Dr, Park City, UT 84098-7605 | 2019-05-13 |
| 1336508696 | Kate Wigman | Physical Therapy Assistant | 1640 Redstone Center Dr, Suite 200, Park City, UT 84098-7605 | 2016-02-15 |
| 1811368087 | Laura Ely | Occupational Therapist | 1640 Redstone Center Dr, Suite 200, Park City, UT 84098-7605 | 2015-10-14 |
| 1346616596 | Darrell Larry | Occupational Therapist | 1640 Redstone Center Dr, Suite 200, Park City, UT 84098-7605 | 2015-08-11 |
| 1699174615 | Jasima Reynolds | Home Health | 1640 Redstone Center Dr, Suite 200, Park City, UT 84098-7605 | 2014-08-14 |
| 1609275809 | Ryan Robert Holzum | Physical Therapist | 1640 Redstone Center Dr, Park City, UT 84098-7605 | 2014-08-14 |
| 1518215821 | Mona Kazemi | Occupational Therapist | 1640 Redstone Center Dr, Suite 200, Park City, UT 84098-7605 | 2012-08-16 |
| 1114289386 | Dana P. Nelson | Occupational Therapy Assistant | 1640 Redstone Center Dr, Suite #200, Park City, UT 84098-7605 | 2012-06-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972069532 | Natasha Nicolle Peterson | Nurse Practitioner | Stat Md, 1784 Uinta Way E, Park City, UT 84098 | 2019-02-19 |
| 1750732079 | Rebecca Hansen | Physical Therapist | 1640 W Redstone Center Dr, Suite 200, Park City, UT 84098 | 2016-06-28 |
| 1497126130 | Megan Franz | Counselor | 3100 Pinebrook Rd, Park City, UT 84098 | 2015-10-07 |
| 1568752541 | Kortney James Stirland | Pharmacist | 750 Round Valley Drive #203, Park City, UT 84098 | 2011-04-12 |
| 1265763379 | Amy S Koch | Physical Therapy Assistant | 1640 West Redstone Drive, Suite 200, Park City, UT 84098 | 2010-01-29 |
| 1134374648 | Donna B Fischer | General Practice | 6531 N Landmark Dr., Park City, UT 84098 | 2008-11-25 |
| 1962659458 | Patricia A Lindsay Phd Inc | Psychologist | 1743 W Redstone Ctr Dr, #115, Park City, UT 84098 | 2008-08-26 |
| 1437314291 | Jeffrey S Holverson | Internal Medicine | 6240 N Snowview Dr, Park City, UT 84098 | 2008-07-22 |
| 1578728515 | Blair Archbold Smith | Physical Therapist | 6880 Canyon Drive Court, Park City, UT 84098 | 2008-07-18 |
| 1821255274 | Beth Anita Rylands | Physical Therapy Assistant | 1640 W. Redstone Center Dr., Suite 200, Park City, UT 84098 | 2008-05-21 |
| Find all providers in zip 84098 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790261162 | Amy Zarbock | Licensed Practical Nurse | 1917 E Foxmoor Pl, Sandy, UT 84092-5261 | 2018-07-18 |
| 1790275451 | Karen Ruth Anderson | Licensed Practical Nurse | 8540 S 100 E, Sandy, UT 84070-1582 | 2018-05-17 |
| 1346606522 | Katherine Olsen Wilkinson | Licensed Practical Nurse | 247 E 1090 N, Orem, UT 84057-3207 | 2016-01-04 |
| 1376909614 | Jack Y. Webb Jr. | Licensed Practical Nurse | 1842 E 2900 S, Naples, UT 84078-5110 | 2015-12-31 |
| 1023473931 | Robyn L Delgado | Licensed Practical Nurse | 2319 N 790 W, Lehi, UT 84043-2841 | 2015-12-18 |
| 1225400534 | Paul Jones | Licensed Practical Nurse | 6822 East / 1000 South, Fort Duchesne, UT 84026 | 2015-10-26 |
| 1184042236 | Revive Health Center of Utah LLC | Licensed Practical Nurse | 3080 N Fairfield Rd, Suite 1, Layton, UT 84041-8694 | 2014-04-04 |
| 1467876920 | Angela Thorpe | Licensed Practical Nurse | 1995 S 1275 E, Ogden, UT 84401-0761 | 2014-02-04 |
| 1265861751 | Tina Earl | Licensed Practical Nurse | 5965 S 900 E # Eat, Murray, UT 84121-1720 | 2013-11-05 |
| 1588097521 | Brandon Ray Fowler | Licensed Practical Nurse | 9675 N 5750 W, Highland, UT 84003-9150 | 2013-08-13 |
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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.