DR. JEREMY W ELLIS (NPI# 1568558468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568558468 |
| Entity Type | Individual |
| Full Name | DR. JEREMY W ELLIS |
| Credential | D.D.S. |
| Practice Address |
965 S 100 W #102 Logan UT 84321-6062 |
| Practice Telephone | 4357529741 |
| Practice Fax Number | 4357535169 |
| Mailing Telephone | 4357529741 |
| Mailing Fax Number | 4357535169 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
99-373-9289922 | UT | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740663905 | Jeremy Ellis | Chiropractor | 4901 Friedman Ln, Fort Worth, TX 76244-6121 | 2015-07-07 |
| 1316403967 | Jeremy Ellis | Case Manager/Care Coordinator | 2626 Charles Dr, Chalmette, LA 70043-3779 | 2019-02-19 |
| 1306359393 | Jeremy Ellis | Counselor | 48 Private Drive 339, South Point, OH 45680-8919 | 2017-11-13 |
| 1003369430 | Jeremy Ellis | Counselor | 1501 Yarmouth Ave, Boulder, CO 80304-0564 | 2016-08-02 |
| 1255652525 | Jeremy Michael Ellis | Internal Medicine | 1240 S Cedar Crest Blvd, Suite 410, Allentown, PA 18103-6369 | 2010-06-21 |
| Street Address |
965 S 100 W #102 |
| City | LOGAN |
| State | UT |
| Zip Code | 84321-6062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003853672 | Alliance Home Health of Northern Utah, LLC | Home Health | 965 S 100 W, Ste. 204, Logan, UT 84321-6062 | 2006-06-01 |
| 1487895983 | Joseph Anderson, D.c., Pllc | Health Maintenance Organization | 965 S 100 W, Suite 105, Logan, UT 84321-6062 | 2009-03-12 |
| 1497922835 | Steven D Fisher | Chiropractor | 965 S 100 W, Ste 105, Logan, UT 84321-6062 | 2008-05-14 |
| 1184816522 | Advanced Spine & Health Center | Chiropractor | 965 S 100 W, Ste. 105, Logan, UT 84321-6062 | 2007-08-09 |
| 1114128022 | Tim B Belnap | Dentist | 965 S 100 W, Suite 100, Logan, UT 84321-6062 | 2007-05-29 |
| 1467582155 | Norma Jean Peck | Social Worker | 965 S 100 W, Suite 203, Logan, UT 84321-6062 | 2007-03-06 |
| 1093881799 | Jeannine Deborah Nielson | Counselor | 965 S 100 W, Suite 203, Logan, UT 84321-6062 | 2006-11-27 |
| 1124133855 | Hospice Alliance of Utah, LLC | Hospice Care, Community Based | 965 S 100 W, Suite 204, Logan, UT 84321-6062 | 2006-08-21 |
| 1265547699 | Laurel Carter | Counselor | 965 S 100 W, #203, Logan, UT 84321-6062 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265074157 | Grant E Severe | Pharmacist | 175 E 442 N, Logan, UT 84321 | 2019-10-11 |
| 1437712585 | Gregory Scott Hansen | Pharmacist | 412 East 200 North, Logan, UT 84321 | 2019-04-15 |
| 1043701584 | Mckell Peidl | Behavior Technician | 240 E 400 N Apt 8, Logan, UT 84321 | 2018-05-21 |
| 1801331194 | Eric Dutson | Speech-Language Pathologist | 964 W 2880 S, Nibley, UT 84321 | 2016-12-22 |
| 1063805299 | Krystal Cox | Marriage & Family Therapist | 493 North 700 East, Logan, UT 84321 | 2015-03-12 |
| 1013340801 | Carly D. L. Lebaron | Marriage & Family Therapist | 95 W. 100 S., Suite 360, Logan, UT 84321 | 2013-08-15 |
| 1669710471 | Brandon Bailey | Counselor | 1465 N. 300 W., Ste. A, Brigham, UT 84321 | 2013-01-29 |
| 1871843086 | Brandi Lee Richins | Social Worker | 90 E. 200 N., Logan, UT 84321 | 2012-09-14 |
| 1922356732 | Stacy Lynn Hamilton Jones | Marriage & Family Therapist | 60 East Center Street, Suite 205, Keystone Family Solutions, Logan, UT 84321 | 2012-08-28 |
| 1992002455 | Robert Thomas Allred | Chiropractor | 944 South Highway 89/91, Logan, UT 84321 | 2011-02-18 |
| Find all providers in zip 84321 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073165007 | Joshua Joel Burnham | Dentist | 957 S Hwy 89, Logan, UT 84321-5451 | 2019-07-10 |
| 1295398352 | Cache Valley Dental Associates LLC | Dentist | 120 W Cache Valley Blvd Ste 200, Logan, UT 84341-2697 | 2019-04-15 |
| 1326530486 | Brad C Theurer | Dentist | 1340 N 600 E Ste 1, Logan, UT 84341-2475 | 2018-06-05 |
| 1609304294 | Clayton Franklin Gunnell | Dentist | 1320 N 600 E Ste 2, Logan, UT 84341-2474 | 2017-05-26 |
| 1295961159 | Travis S. Baldwin | Dentist | 1260 N 200 E, Suite 9, Logan, UT 84341-7560 | 2009-06-05 |
| 1386804458 | Justin Carter | Dentist | 1451 N 200 E, Suite #200, Logan, UT 84341-7570 | 2008-06-12 |
| 1144427154 | Larry T Hogge | Dentist | 1230 N 200 E, Logan, UT 84341 | 2007-07-02 |
| 1013112978 | Cameron Mark Workman | Dentist | 150 E 200 N Ste C, Logan, UT 84321-4036 | 2007-06-19 |
| 1457556813 | Scott L Theurer | Dentist | 1340 N 600 E, Ste 1, Logan, UT 84341-2440 | 2007-06-18 |
| 1104029560 | Samuel Lee Peery | Dentist | 30 N 100 E, Logan, UT 84321-4649 | 2007-06-06 |
| Find all providers in LOGAN | ||||
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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.