MR. SCOTT ALAN LANGE (NPI# 1104801315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104801315 |
| Entity Type | Individual |
| Full Name | MR. SCOTT ALAN LANGE |
| Credential | PA |
| Practice Address |
1134 N 500 W Suite 100 Provo UT 84604-3383 |
| Mailing Address |
Po Box 27128 Salt Lake City UT 84127-0128 |
| Practice Telephone | 8013577081 |
| Mailing Telephone | 8013577081 |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2010-07-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
6224324-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA00880 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730620683 | Scott Lange | Specialist/Technologist | 13430 Barons Lake Ln, Cypress, TX 77429-5590 | 2017-03-12 |
| 1114181815 | Scott Thomas Lange | Radiologic Technologist | 1535 Gull Rd Ste 200, Kalamazoo, MI 49048-1638 | 2008-07-11 |
| Street Address |
1134 N 500 W SUITE 100 |
| City | PROVO |
| State | UT |
| Zip Code | 84604-3383 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063410579 | Robert H Crawford | Family Medicine | 1134 N 500 W, Suite 102, Provo, UT 84604-3383 | 2005-07-08 |
| 1487170940 | Devery Larsen | Speech-Language Pathologist | 1134 N 500 W, Provo, UT 84604-3383 | 2017-08-16 |
| 1215323399 | Zachary John Pugh | Internal Medicine | 1134 N 500 W, Provo, UT 84604-3383 | 2015-04-15 |
| 1275937849 | Melanie S Livingston | Registered Nurse | 1134 N 500 W, Provo, UT 84604-3383 | 2014-10-10 |
| 1285048363 | Reece Baker | Emergency Medicine | 1134 N 500 W, Provo, UT 84604-3383 | 2014-06-17 |
| 1417374737 | Steven Nelson | Emergency Medicine | 1134 N 500 W, Provo, UT 84604-3383 | 2014-03-25 |
| 1477812691 | Marquelle Rogers | Nurse Practitioner | 1134 N 500 W, Suite #101, Provo, UT 84604-3383 | 2012-05-08 |
| 1194083980 | Kristopher Michael Foote | Anesthesiology | 1134 N 500 W, Provo, UT 84604-3383 | 2012-04-30 |
| 1356617518 | Nathan Allen Rainwater | Internal Medicine | 1134 N 500 W, Suite 101, Provo, UT 84604-3383 | 2012-03-31 |
| 1659672459 | Ihc Health Services Inc | Internal Medicine | 1134 N 500 W, Ste 103, Provo, UT 84604-6102 | 2010-11-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
| Find all providers in zip 84604 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164666061 | Stephen A Loper | Physician Assistant | 1055 N 500 W Ste 211, Provo, UT 84604-3305 | 2009-04-23 |
| 1255517488 | William R. Mathie | Physician Assistant | 1055 N 500 W Ste 121, Provo, UT 84604-3305 | 2008-01-17 |
| 1023352952 | Joan Margaret Butler | Physician Assistant | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2012-11-15 |
| 1588928097 | Brady Charles Norton | Physician Assistant | 1055 N 500 W, Provo, UT 84604-3305 | 2012-06-28 |
| 1184984320 | Daniel Christensen | Physician Assistant | 1055 N 500 W Ste 207, Provo, UT 84604-3305 | 2012-05-22 |
| 1184930786 | Drew Kenner Lambourne | Physician Assistant | 1055 N 500 W, Suite 121, Provo, UT 84604-3305 | 2010-08-20 |
| 1851625255 | Jami Z Mckell | Physician Assistant | 1034 N 500 W, Provo, UT 84604-3380 | 2009-10-01 |
| 1730318445 | Stephen Cruze | Physician Assistant | 1055 N 500 W, Suite 121, Provo, UT 84604-3305 | 2009-07-02 |
| 1205024122 | David Wesley Brock | Physician Assistant | 3550 N University Ave, Suite 250, Provo, UT 84604-6683 | 2007-10-04 |
| 1255371878 | Adam C Phillips | Physician Assistant | 1034 N 500 W, Provo, UT 84604-3380 | 2006-06-08 |
| Find all providers in PROVO | ||||
Please comment or provide details below to improve the information on MR. SCOTT ALAN LANGE.
| 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.