ROBERT DERREL JOHNSTUN (NPI# 1578118659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578118659 |
| Entity Type | Individual |
| Full Name | ROBERT DERREL JOHNSTUN |
| Practice Address |
1160 E 3900 S Ste 5000 Salt Lake City UT 84124-1275 |
| Mailing Address |
Po Box 100253 Atlanta GA 30384-1221 |
| Practice Telephone | 8012617479 |
| Practice Fax Number | 8012617429 |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2020-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 8508793-4405 | UT | Allopathic & Osteopathic Physicians |
| Y | 363L00000X | Nurse Practitioner | 8508793-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1160 E 3900 S STE 5000 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84124-1275 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487646998 | Robert B Bourne | Orthopaedic Surgery | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2005-08-19 |
| 1407407679 | Francisco Jose Hurtado Iv | Physician Assistant | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2019-09-27 |
| 1508424870 | Alex Ann Anderson | Physical Therapist | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2019-06-03 |
| 1811488976 | Alexa Victoria Nickel | Registered Nurse | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2018-05-24 |
| 1679002190 | Chase Naylor | Physician Assistant | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2017-06-08 |
| 1063764629 | Craig Robert Schumann | Physician Assistant | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2012-10-08 |
| 1700149572 | Oliver Brant Nikolaus | Orthopaedic Surgery | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2012-06-18 |
| 1992859524 | David P Stefl | Physician Assistant | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2007-01-22 |
| 1033123179 | Jeffrey D Jackson | Orthopaedic Surgery | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2006-07-27 |
| 1275576274 | Tony Landon Miller | Physician Assistant | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2006-06-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487273298 | Shannon Penny Price | Social Worker | 4465 Maybeck Place, Condo C, Millcreek, UT 84124 | 2020-04-11 |
| 1922654367 | Joseph C Melvin Md PC | Colon & Rectal Surgery | 1250 East 3900 South Ste 320, Salt Lake City, UT 84124 | 2019-08-12 |
| 1366923252 | Melanie Stumpf | Counselor | 1141 E 3900, Suite A170, Salt Lake City, UT 84124 | 2018-08-28 |
| 1376033993 | Michelle Flowers | Speech-Language Pathologist | 2120 East 3900 South, Ste 200, Holladay, UT 84124 | 2018-05-18 |
| 1740797257 | Lissa Anne Hutchings | Nurse Practitioner | 1160 E 3900 S Ste 4100, Salt Lake City, UT 84124 | 2018-01-05 |
| 1316465693 | Randy Gines | Counselor | 4460 S Highland Drive # 230, Murray, UT 84124 | 2017-09-06 |
| 1417470717 | Joshua Chandler Spencer | Counselor | 4460 South Highland Dr., 230, Murray, UT 84124 | 2017-07-19 |
| 1659891554 | Marcus Whitney | Counselor | 4460 S Highland Dr. # 230, Murray, UT 84124 | 2017-06-21 |
| 1518496884 | Courtney Nilson | Counselor | 4460 S. Highland Dr. #230, Murray, UT 84124 | 2017-06-08 |
| 1841687126 | Intrafilrx | Preferred Provider Organization | 3920 S 1100 E Ste 210, Salt Lake City, UT 84124 | 2015-04-23 |
| Find all providers in zip 84124 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467085019 | Hillary Price | Nurse Practitioner | 30 N Medical Drive, Salt Lake City, UT 84132-0001 | 2020-02-21 |
| 1467093328 | Tessa Rachel Curtis | Nurse Practitioner | 1160 E 3900 S Ste 3100, Salt Lake City, UT 84124-1202 | 2019-10-02 |
| 1033773544 | Marathon Health, LLC | Nurse Practitioner | 1930 S State St, Salt Lake City, UT 84115-2311 | 2019-04-30 |
| 1912488347 | Wendy Jane Frey | Nurse Practitioner | 3490 E Hermes Dr, Salt Lake City, UT 84124-3211 | 2018-08-23 |
| 1851813299 | Wayne Berg | Nurse Practitioner | 1060 E 100 S Ste 110, Salt Lake City, UT 84102-1591 | 2017-07-07 |
| 1982051785 | Patricia M Starks | Nurse Practitioner | 2678 S Glenmare St, Salt Lake City, UT 84106-3606 | 2016-05-21 |
| 1215392287 | Chad Dorman Dansie | Nurse Practitioner | 200 N Mario Capecchi Dr, Salt Lake City, UT 84132-0001 | 2015-12-17 |
| 1346642121 | Randi Moore Hollis | Nurse Practitioner | 1220 E 3900 S Ste 1f, Salt Lake City, UT 84124-1327 | 2014-09-23 |
| 1699049866 | Keri Page | Nurse Practitioner | 100 Mario Capecchi Dr Ste 2600, Salt Lake City, UT 84113-1103 | 2012-03-05 |
| 1710267877 | Trudy L. Hardin-reynolds | Nurse Practitioner | 825 Northcrest Dr, Salt Lake City, UT 84103-3320 | 2011-08-22 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84124 |
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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.