MR. BRUCE WARELO SPERRY (NPI# 1760575518) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760575518 |
| Entity Type | Individual |
| Full Name | MR. BRUCE WARELO SPERRY |
| Credential | PT, PA-C |
| Practice Address |
500 Foothill Blvd # 112 Salt Lake City UT 84148-0001 |
| Mailing Address |
11747 Beau Meadow Ln Draper UT 84020-4513 |
| Practice Telephone | 8015281565 |
| Practice Fax Number | 8015842587 |
| Mailing Telephone | 8015821565 |
| Mailing Fax Number | 8015842587 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
116471-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
500 FOOTHILL BLVD # 112 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84148-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598211799 | Jacquelyn Rae Contant | Dietitian, Registered | 500 Foothill Dr. (120), Salt Lake City, UT 84148 | 2016-08-28 |
| 1699127811 | Taylor Alford | Pharmacist | 500 Foothills Drive, Salt Lake City, UT 84148 | 2016-07-12 |
| 1356792162 | Sarah Hummel | Genetic Counselor, MS | 500 Foothill Drive, Sarah Hummel, Va Salt Lake City, Genomic Medicine (10p4e), Salt Lake City - Salt Lake, UT 84148 | 2016-06-23 |
| 1174936140 | Elizabeth Shade Cardenas | Nurse Practitioner | 500 Foothill Drive #182h, Veterans Healthcare Administration, Salt Lake City, UT 84148 | 2014-06-08 |
| 1386904043 | David Earl Moore | Specialist | 500 Foothill Blvd (research), George E. Wahlen Va Healthcare System, Salt Lake City, UT 84148 | 2012-05-29 |
| 1790059038 | Deborah Ernstein Holley Hartzfeld | Genetic Counselor, MS | 615 Arapeen Drive #212, Salt Lake City, UT 84148 | 2012-03-05 |
| 1073823720 | Diana Lynn Robbins | Social Worker | 9140 W. Post Road, Las Vegas, NV 84148 | 2010-10-15 |
| 1659534394 | Katherine Margaret Dunn | Genetic Counselor, MS | 500 Foothill Drive (151z), Salt Lake City, UT 84148 | 2008-07-02 |
| 1730381625 | Douglas James Ball | Medical Genetics | Va Salt Lake City Health Care System 10p11, Salt Lake City, UT 84148 | 2007-06-03 |
| 1245339530 | Daniel H Priestly | Radiology | 500 Foothill Dr., Salt Lake City, UT 84148 | 2006-09-22 |
| Find all providers in zip 84148 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1912130311 | Andrew M Strong | Physician Assistant | 5323 Woodrow St Ste 202, Salt Lake City, UT 84107-5848 | 2009-09-01 |
| 1104005503 | Michael A. Pond | Physician Assistant | Fairfax Rd At Virginia St, Salt Lake City, UT 84103-4399 | 2007-11-01 |
| 1801448378 | Meghan Deyoung | Physician Assistant | 30 N 1900 E, Salt Lake City, UT 84132-0002 | 2019-07-15 |
| 1386119279 | Westley Hunsaker | Physician Assistant | 375 S Chipeta Way, Salt Lake City, UT 84108-1260 | 2018-10-08 |
| 1891277950 | Brittany Marie Cross | Physician Assistant | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2018-09-05 |
| 1609382050 | Samuel Stephen Richards | Physician Assistant | 5848 S Fashion Blvd Ste 110, Salt Lake City, UT 84107-6175 | 2017-12-21 |
| 1396283248 | Bradley Orin Stevens | Physician Assistant | 5848 S Fashion Blvd Ste 110, Salt Lake City, UT 84107-6175 | 2017-02-10 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84148 |
Please comment or provide details below to improve the information on MR. BRUCE WARELO SPERRY.
| 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.