TYLER J RUNDELL (NPI# 1861962912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861962912 |
| Entity Type | Individual |
| Full Name | TYLER J RUNDELL |
| Credential | PA-C |
| Practice Address |
585 Main St Green River UT 84525 |
| Mailing Address |
4325 S Doreen Cir Millcreek UT 84107-2816 |
| Practice Telephone | 4355643434 |
| Mailing Telephone | 6073163109 |
| Enumeration Date | 2018-12-03 |
| Last Update Date | 2018-12-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 10877596-8906 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | UTAH DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING | 10877596-8906 | 01 |
| UT | UTAH DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING | 10877596-1206 | 01 |
| NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS | 1152696 | 01 |
| Street Address |
585 MAIN ST |
| City | GREEN RIVER |
| State | UT |
| Zip Code | 84525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871061929 | Zackery N Taylor | Pharmacist | 585 W Main St, Green River, UT 84525 | 2018-11-07 |
| 1689134868 | Green River Medical Center, Inc. | Pharmacy | 585 West Main Street, Green River, UT 84525 | 2019-03-22 |
| 1841540077 | Green River Medical Center Inc | Pharmacy | 585 West Main Street, Green River, UT 84525 | 2012-09-14 |
| 1821243684 | Shannon Taylor Thurston | Physician Assistant | 585 West Main Street, Green River, UT 84525 | 2008-11-20 |
| 1497840987 | Loye West | Physician Assistant | 305 West Main Street, Green River, UT 84525 | 2006-10-03 |
| 1043648108 | Amber Dawn Fowler | Counselor | 585 W. Main Street, Green River, UT 84525-0417 | 2013-10-28 |
| 1942317722 | Green River Medical Center Inc | Clinic/Center | 585 West Main St., Box 417, Green River, UT 84525-0417 | 2006-08-25 |
| 1326081084 | Kim Thyrill Mcfarlane | Physician Assistant | 585 West Main Street, Green River, UT 84525-0417 | 2006-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205440443 | Jeanette Paladino | Case Manager/Care Coordinator | 360 Greasewood St, Green River, WY 82935-4722 | 2020-09-04 |
| 1760094411 | Shannon Christine Miller | Respite Care | 1750 New Mexico St, Green River, WY 82935-6252 | 2020-08-22 |
| 1467060301 | Roy Allen Lloyd | Case Management | 345 Anvil Dr Apt B, Green River, WY 82935-5487 | 2020-07-16 |
| 1205474160 | Matthew Gelston Herron | Case Manager/Care Coordinator | 700 Shoshone Ave Unit 26, Green River, WY 82935-5558 | 2019-12-11 |
| 1841854544 | Hilary Violet Hollihan Leavitt | Case Manager/Care Coordinator | 2030 Wyoming Dr, Green River, WY 82935-5851 | 2019-04-28 |
| 1427528488 | Richard Percifield | Counselor | 400 N 1st East St Ste 107a, Green River, WY 82935-4247 | 2018-12-03 |
| 1437660131 | Jennifer Ann Brown | Speech-Language Pathologist | 215 Maple Cir, Green River, WY 82935-4765 | 2017-10-20 |
| 1306376975 | Nicholas Henry Hastert | Physical Therapist | 330 Upland Way, Green River, WY 82935 | 2017-06-15 |
| 1073054508 | Jodie S Hix | Physical Therapy Assistant | 1715 Hitching Post Drive, Green River, WY 82935-6600 | 2017-03-16 |
| 1376089581 | Complete Chiropractics LLC | Chiropractor | 170 Commerce Dr Ste A, Green River, WY 82935-6156 | 2017-01-11 |
| Find all providers in GREEN RIVER | ||||
| 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 |
|---|---|---|---|---|
| 1215285366 | Joel Robertson | Physician Assistant | 1400 Uinta Dr, Green River, WY 82935-5060 | 2012-08-21 |
| 1497840987 | Loye West | Physician Assistant | 305 West Main Street, Green River, UT 84525 | 2006-10-03 |
| 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 | ||||
| City | GREEN RIVER |
| Zip Code | 84525 |
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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.