WAYMORE SHADE LLC (NPI# 1043874332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043874332 |
| Entity Type | Organization |
| Organization Name | WAYMORE SHADE LLC |
| Practice Address |
451 S Main St Ste 1 Springville UT 84663-2293 |
| Practice Telephone | 8018054744 |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2019-04-23 |
| Authorized Official Name | ISAAC BRYAN (DERMATOLOGIST) |
| Authorized Official Telephone | 8018054744 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Summit Dermatology | Doing Business As Name - Organization |
| Street Address |
451 S MAIN ST STE 1 |
| City | SPRINGVILLE |
| State | UT |
| Zip Code | 84663-2293 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659900835 | Change Academy At Lake of The Ozarks | Residential Treatment Facility, Emotionally Disturbed Children | 266 South Left Fork Hobble Creek Canyon Road, Springville, UT 84663 | 2020-04-08 |
| 1780215269 | Reboot Centers Hobble Creek | Clinical Neuropsychologist | 1154 Left Fork Hobble Creek Canyon Rd, Springville, UT 84663 | 2020-02-03 |
| 1063053866 | Jesus Lopez | Clinic/Center | 1461 Archmore Loop, Springville, UT 84663 | 2019-10-02 |
| 1689109506 | Cd Pharmacy LLC | Pharmacy | 863 W 450 S, Suite 201, Springville, UT 84663 | 2017-04-28 |
| 1215479225 | Jaydynn Cusworth | Behavior Technician | 692 S 2800 W Unit I 101, Springville, UT 84663 | 2016-11-08 |
| 1245699602 | Pamela Jamison | Speech-Language Pathologist | 1072 Wildflower Way, Springville, UT 84663 | 2016-02-14 |
| 1013397348 | Lindsay Erickson | Counselor | 470 Buckley Ave, Springville, UT 84663 | 2015-06-02 |
| 1790084903 | Grant Lee Murdoch | Counselor | 1102 N 850 W, Springville, UT 84663 | 2011-03-28 |
| 1306148739 | Siuta Sonny Faaootoa | Counselor | 551 North Main Street, Springville, UT 84663 | 2010-11-17 |
| 1891000790 | Christopher David Westover | Social Worker | 716 N 200 E, Springville, UT 84663 | 2010-08-16 |
| Find all providers in zip 84663 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629505839 | Thomas Alan Dutra | Dermatology | 732 N Main St, Springville, UT 84663-1034 | 2017-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245863893 | Central Utah Dermatology | Dermatology | 861 N Main, Richfield, UT 84701 | 2020-02-21 |
| 1548810401 | Smart & Gibbs | Dermatology | 3200 W Clubhouse Dr Ste 100, Lehi, UT 84043-4325 | 2019-09-12 |
| 1598261869 | Tuttle Dermatology PC | Dermatology | 617 E Riverside Dr Ste 103, St George, UT 84790-8049 | 2018-04-04 |
| 1770099251 | Ihc Health Services Inc | Dermatology | 395 W Bulldog Blvd Ste 604, Provo, UT 84604-3331 | 2017-12-20 |
| 1417467986 | Red Ledges Dermatology Pllc | Dermatology | 1449 N 1400 W Ste 22, St George, UT 84770-5237 | 2017-10-10 |
| 1649724139 | University of Utah Adult Services | Dermatology | 165 N. University Ave. Farmington, Farmington, UT 84025 | 2016-08-12 |
| 1861861155 | Brent H. Goodsell, Do | Dermatology | 162 S 1100 E, American Fork, UT 84003-2817 | 2015-09-17 |
| 1912316654 | Jeanna Tachiki Ryan | Dermatology | 243 E 6100 S, Murray, UT 84107-7302 | 2014-08-07 |
| 1659785889 | Dana Rice | Dermatology | 6095 S Fashion Blvd Ste 270, Murray, UT 84107-7387 | 2014-06-16 |
| 1548680184 | West Valley Dermatology | Dermatology | 3465 S Pioneer Pkwy, Suite 1, Salt Lake City, UT 84120-2076 | 2014-04-22 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGVILLE |
| Zip Code | 84663 |
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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.