RICHARD BRENNAN BLACKHAM (NPI# 1043470990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1043470990 |
Entity Type | Individual |
Full Name | RICHARD BRENNAN BLACKHAM |
Credential | M.D. |
Practice Address |
5171 S Cottonwood St Suite, 810 Murray UT 84107-5704 |
Practice Telephone | 8015079800 |
Practice Fax Number | 8015079801 |
Mailing Telephone | 8015059800 |
Mailing Fax Number | 8015079801 |
Enumeration Date | 2008-06-13 |
Last Update Date | 2013-08-30 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
8627317-1205 | UT | Allopathic & Osteopathic Physicians |
N | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
46108 | AZ | Allopathic & Osteopathic Physicians |
Street Address |
5171 S COTTONWOOD ST SUITE, 810 |
City | MURRAY |
State | UT |
Zip Code | 84107-5704 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780201293 | Heather Patricia Nick | Genetic Counselor, MS | 5171 S Cottonwood St, Murray, UT 84107-5704 | 2020-06-30 |
1245743640 | Brigid A O'donnell | Nurse Practitioner | 5171 S Cottonwood St, Murray, UT 84107 | 2017-11-08 |
1568917664 | Amanda Peterson | Occupational Therapist | 5171 S Cottonwood St, Lower Level 2 Women's Center Coordinated Rehab Services, Murray, UT 84107-5704 | 2016-08-18 |
1336590595 | Kassie Burton | Nurse Practitioner | 5171 S Cottonwood St, Ste 740, Murray, UT 84107-5704 | 2016-06-28 |
1548636848 | Amy Berrigan | Nurse Practitioner | 5171 S Cottonwood St, Suite 740, Murray, UT 84107-5704 | 2015-08-20 |
1487042065 | Kimberly Chesney Redford | Audiologist | 5171 S Cottonwood St, Suite 140, Murray, UT 84107-5704 | 2015-01-05 |
1881007508 | Janelle Hayes | Physical Therapist | 5171 S Cottonwood St, Suite 810, Murray, UT 84107-5704 | 2014-06-10 |
1316373087 | Ihc Health Services Inc | Internal Medicine | 5171 S Cottonwood St, Ste 350, Murray, UT 84107-5733 | 2013-09-25 |
1376976381 | Laura K Heermann Langford | Registered Nurse | 5171 S Cottonwood St, Suite 220, Murray, UT 84107-5704 | 2013-08-13 |
1023459393 | Rachelle Jelosek | Nurse Practitioner | 5171 S Cottonwood St, Suite 810, Murray, UT 84107-5704 | 2013-07-15 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
Find all providers in zip 84107 |
Taxonomy Code | 2081P2900X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Physical Medicine & Rehabilitation |
Specialization | Pain Medicine |
A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942560479 | Joshua J Minori | Physical Medicine & Rehabilitation | 5801 S Fashion Blvd, Murray, UT 84107-6159 | 2012-05-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194144329 | Austin Lebron Albright | Physical Medicine & Rehabilitation | 6360 S 3000 E Ste 200, Salt Lake City, UT 84121-6925 | 2014-04-15 |
1255691986 | Gregory Lyman Condie | Physical Medicine & Rehabilitation | 3838 S 700 E # 300, Slc, UT 84106-1466 | 2012-05-29 |
1104060714 | Comprehensive Medical Management, PC | Physical Medicine & Rehabilitation | 4052 W Pioneer Parkway, Suite 208, West Valley City, UT 84120 | 2009-04-27 |
1407026420 | Qamar Khan | Physical Medicine & Rehabilitation | 661 W 10600 S, South Jordan, UT 84095-8524 | 2008-03-05 |
1942492079 | Edgar Clinton Goldston Jr. | Physical Medicine & Rehabilitation | 175 North Medical Drive East, Salt Lake City, UT 84132-2303 | 2007-08-13 |
1871799528 | Cole W Robinson | Physical Medicine & Rehabilitation | 860 N Main St Ste B, Richfield, UT 84701-1840 | 2007-06-21 |
1285673434 | David James Peifer | Physical Medicine & Rehabilitation | George E. Wahlen Veterans Administration Medical C, 500 Foothill Dr, Salt Lake City, UT 84148-0001 | 2006-06-05 |
1154312197 | Bradley Dryden Root | Physical Medicine & Rehabilitation | 1424 E Foremaster Dr Ste 120, St George, UT 84790-5844 | 2005-10-31 |
1225036064 | Brian K Olenslager | Physical Medicine & Rehabilitation | 3585 N University Ave, Ste 150, Provo, UT 84604-6601 | 2005-07-13 |
1861490278 | Corey D Anden | Physical Medicine & Rehabilitation | 4403 Harrison Blvd Ste 1875, Ogden, UT 84403-3325 | 2005-07-09 |
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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.