SHARI BLOOM (NPI# 1053564179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053564179 |
| Entity Type | Individual |
| Full Name | SHARI BLOOM |
| Credential | PA-C |
| Practice Address |
1665 Bonanza Dr Park City UT 84060-5127 |
| Mailing Address |
Po Box 27128 Salk Lake City UT 84127-0128 |
| Practice Telephone | 4356497640 |
| Practice Fax Number | 4356491365 |
| Mailing Telephone | 8014916482 |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2012-09-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
MT0903117 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1665 BONANZA DR |
| City | PARK CITY |
| State | UT |
| Zip Code | 84060-5127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265439236 | Stefani Jane Day | Family Medicine | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2005-07-05 |
| 1437692324 | Ihc Health Services Inc | Preventive Medicine | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2016-11-23 |
| 1417223892 | Tin Vuong | Family Medicine | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2012-03-29 |
| 1457622706 | Cody Allen Walker | Pharmacist | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2012-01-18 |
| 1447534169 | Amy Beth Arriola | Physician Assistant | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2011-09-29 |
| 1730462110 | Pharmacy At Park City Clinic | Pharmacy | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2011-09-22 |
| 1639406705 | Mary Catherine Schindeler | Physician Assistant | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2009-11-11 |
| 1528183597 | Ihc Health Services | Clinic/Center | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2007-03-20 |
| 1124132113 | Pc Pharmacy At The Clinic Inc | Pharmacy | 1665 Bonanza Dr, Park City, UT 84060 | 2006-08-18 |
| 1861423113 | Cress Roy Bohnn | Legal Medicine | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2006-07-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982233920 | Livecare, Inc. | Nursing Care | 1830 Prospector Avenue, Park City, UT 84060 | 2020-04-02 |
| 1063904266 | Louise Knetzger Gallagher | Acupuncturist | 1107 Woodside Ave, Park City, UT 84060 | 2018-06-04 |
| 1942753421 | Valerie Alison Mey | Dietitian, Registered | 2985 Arabian Dr, Park City, UT 84060 | 2016-08-01 |
| 1659720936 | Vibrant Health PC | Anesthesiology | 1910 Prospector Ave Suite 302, Park City, UT 84060 | 2016-06-08 |
| 1538538657 | Pamela Hilbert | Dentist | 1830 Prospector Ave., Park City, UT 84060 | 2015-09-18 |
| 1174904924 | Julie Anna Bullen | Counselor | 2300 Monitor Drive, Park City, UT 84060 | 2015-06-17 |
| 1265825319 | William Gary Smith | Obstetrics & Gynecology | 2501 Creek Drive, Park City, UT 84060 | 2015-03-13 |
| 1497026330 | Earl Warren Stadler Jr. | Physical Medicine & Rehabilitation | 1500 Three Kings Drive Unit 31, Park City, UT 84060 | 2012-01-24 |
| 1538454541 | Belinda Duncan | Pharmacist | 2700 E Deer Valley Dr B105, Park City, UT 84060 | 2011-06-17 |
| 1184888315 | Cody Michael Calderwood | Dentist | 1600 Snow Creek Dr Ste A, Park City, UT 84060 | 2008-07-16 |
| Find all providers in zip 84060 | ||||
| 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 |
|---|---|---|---|---|
| 1144844218 | Rebecca E Escoto | Physician Assistant | 3064 Creek Rd, Park City, UT 84098-4843 | 2020-06-03 |
| 1841710654 | Rachelle Flinn | Physician Assistant | 650 Round Valley Dr, Park City, UT 84060-7571 | 2017-06-22 |
| 1144777418 | Kevin Bryan James Huntington | Physician Assistant | 1784 Uinta Way Unit E2, Park City, UT 84098-7685 | 2016-09-05 |
| 1740453703 | Melinda S Roalstad | Physician Assistant | 1526 West Ute Blvd Ste 110, Park City, UT 84098 | 2008-04-10 |
| 1649379413 | Eileen Burke-price | Physician Assistant | 1665 Bonanza Drive, Park City, UT 84060 | 2006-09-21 |
| 1851406011 | Lindsey Elizabeth Marshall | Physician Assistant | 2200 Park Ave. Bldg. D Ste. 100, Park City, UT 84060 | 2006-08-20 |
| 1033117874 | Cynthia C Berwald | Physician Assistant | 2720 Homestead Rd, Suite 100, Park City, UT 84098-4881 | 2005-07-13 |
| 1891343950 | Logan Kupitz | Physician Assistant | 1750 Sidewinder Dr, Park City, UT 84060-7570 | 2019-08-30 |
| 1518519859 | Allison E Mayzel | Physician Assistant | 1784 Uinta Way Unit E2, Park City, UT 84098-7685 | 2019-07-16 |
| 1124589262 | Natalie Marie Plascencia | Physician Assistant | 900 Round Valley Dr Ste 100, Park City, UT 84060-7552 | 2019-03-30 |
| Find all providers in PARK CITY | ||||
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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.