LANDON MITCHEL FAVERO (NPI# 1801363577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801363577 |
| Entity Type | Individual |
| Full Name | LANDON MITCHEL FAVERO |
| Practice Address |
475 N 500 W Vernal UT 84078-1907 |
| Mailing Address |
3608 S 400 E Bountiful UT 84010-5820 |
| Practice Telephone | 8019157265 |
| Mailing Telephone | 8019157265 |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2019-12-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 11240954-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
475 N 500 W |
| City | VERNAL |
| State | UT |
| Zip Code | 84078-1907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205479748 | Wade Oliver Moulton | Pharmacist | 1080 W Hwy 40, Vernal, UT 84078 | 2019-10-28 |
| 1841610383 | Allegiance Addiction Recovery Center | Substance Abuse Rehabilitation Facility | 4430 N Little Valley Road, Vernal, UT 84078 | 2014-04-23 |
| 1689008773 | Ashley Valley Physician Practice, LLC | Occupational Therapist | 1680 W Highway 40 Ste 202, Vernal, UT 84078 | 2013-08-26 |
| 1528371796 | Terry L Smith | Counselor | 1140 W 500 S #9, Vernal, UT 84078 | 2010-07-16 |
| 1619280880 | Cicile M Rios | Counselor | 1140 W 800 S #9, Vernal, UT 84078 | 2010-07-16 |
| 1265754840 | Marjorie Elaine Gardner | Licensed Practical Nurse | 133 S 500 East, Vernal, UT 84078 | 2010-02-23 |
| 1528205853 | Robert Kirkham Jolley | Dentist | 40 West 100 North, Vernal, UT 84078 | 2009-01-08 |
| 1740482025 | Ashley Valley Physician Practice, LLC | Family Medicine | 175 N. 100 W., Suite 202, Vernal, UT 84078 | 2007-05-31 |
| 1265646459 | Ashley Valley Medical Center | Pharmacy | 151 W. 200 N., Vernal, UT 84078 | 2007-05-09 |
| 1629122692 | Brian Prentice Callahan | Dentist | 779 West Us Highway 40, Vernal, UT 84078 | 2007-01-23 |
| Find all providers in zip 84078 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376017657 | Kinsey Reynolds | Physician Assistant | 379 N 500 W, Vernal, UT 84078-1956 | 2019-01-19 |
| 1891121661 | Walter Montgomery Wootton | Physician Assistant | 379 N 500 W, Vernal, UT 84078-1956 | 2013-09-24 |
| 1679906481 | Derek Potter | Physician Assistant | 379 N 500 W, Suite 1a, Vernal, UT 84078-1956 | 2013-08-15 |
| 1265780258 | Joe Porter | Physician Assistant | 872 W Highway 40, Vernal, UT 84078-2416 | 2012-08-22 |
| 1912274432 | Cameron Phillip Hardy | Physician Assistant | 872 W Highway 40, Vernal, UT 84078-2416 | 2011-11-29 |
| 1326037110 | Michael Ernest Cutler | Physician Assistant | 175 N 100 W, 104, Vernal, UT 84078-2049 | 2005-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417556986 | Brittany Tran | Physician Assistant | 2733 W Redwick Ct, Salt Lake City, UT 84129-5901 | 2020-10-25 |
| 1164020830 | Abbey Coburn | Physician Assistant | 6028 S Ridgeline Dr Ste 200, Ogden, UT 84405-6906 | 2020-10-14 |
| 1528674975 | James Christopher Nichols | Physician Assistant | 1746 E 2100 S, Salt Lake City, UT 84106-4165 | 2020-09-21 |
| 1164049201 | Makenzie Bishop | Physician Assistant | 1077 S 810 E, Provo, UT 84606-6390 | 2020-07-05 |
| 1700403995 | Amber Astle | Physician Assistant | 782 Canterbury Ln, Alpine, UT 84004-1255 | 2020-07-03 |
| 1306462304 | Carson Homer | Physician Assistant | 1715 S 40 W, Orem, UT 84058-8409 | 2020-06-25 |
| 1518583566 | Alexanders Fitness Company LLC | Physician Assistant | 245 S 1060 W, Lindon, UT 84042-1606 | 2020-06-24 |
| 1144844218 | Rebecca E Escoto | Physician Assistant | 3064 Creek Rd, Park City, UT 84098-4843 | 2020-06-03 |
| 1841826971 | David Souza | Physician Assistant | 52 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-03-20 |
| 1134751902 | Jacie Anna Mundahl | Physician Assistant | 8th Ave C St E 80, Salt Lake City, UT 84143-0001 | 2020-02-10 |
| 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.