JEREMY BROADHURST


Address: 190 S Highway 165, Providence, UT 84332-9512
Phone: 4357553300

JEREMY BROADHURST (NPI# 1114115664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1114115664
Entity Type Individual
Full Name JEREMY BROADHURST
Credential DO
Practice Address 190 S Highway 165
Providence
UT 84332-9512
Mailing Address Po Box 27128
Salt Lake City
UT 84127-0128
Practice Telephone 4357553300
Mailing Telephone 8013577930
Enumeration Date 2007-10-10
Last Update Date 2012-03-05
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine 6681706-1204 UT Allopathic & Osteopathic Physicians

Office Location

Street Address 190 S HIGHWAY 165
City PROVIDENCE
State UT
Zip Code 84332-9512

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1881292167 3bc Incorporated Pharmacy 435 North Gateway Drive #802, Providence, UT 84332 2020-10-09
1962049932 Wholelife Family Wellness Clinic of Providence Pllc Counselor 169 N Gateway Dr. Suite 170, Providence, UT 84332 2019-12-09
1033503420 Spring Creek Surgical Center, LLC Clinic/Center 65 North Gateway Drive, Suite 3, Providence, UT 84332 2015-03-24
1558751438 Naturopathic Medical, P.C. Naturopath 565 W. 465 N., Suite 150, Providence, UT 84332 2015-01-29
1821421710 Erin Campbell Physical Therapist 267 West Spring Creek Parkway, Providence, UT 84332 2013-08-14
1285981530 Jordan Joseph Hansen Dentist 169 N Gateway Drive, Suite 200, Providence, UT 84332 2012-08-06
1598086720 Cory B Maughan Dermatology 169 N Gateway Dr Ste 100, Providence, UT 84332 2010-06-22
1528299245 South Valley Eyecare Center, Inc. Optometrist 276 Springcreek Pkwy, Providence, UT 84332 2009-07-29
1316134356 Heather Saxton Maughan Speech-Language Pathologist 344 E Edgehill Dr, Providence, UT 84332 2007-10-03
1902021538 Brad L Thomas Physical Therapist 169 Spring Creek Park Way, Suite 140, Providnce, UT 84332 2007-04-17
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1982254876 Jean Ernst Noel Family Medicine 22 Parsonage St # 194, Providence, RI 02903-4758 2019-09-12
1619526217 Jean Simon Joel Edouard Family Medicine 22 Parsonage St # 184, Providence, RI 02903-4758 2019-09-05
1609065804 Stephen W Davis Family Medicine 299 Promenade Street, Nhpri, Providence, RI 02908 2007-10-24
1053443911 Chad Brown Health Center Family Medicine 285a Chad Brown St, Providence, RI 02908-3102 2007-03-09
1679608582 Peachtree Family Medicine PC Family Medicine 169 N Gateway Dr, 170, Providence, UT 84332-9855 2007-02-22
1679647432 Marsha Maxine Miller Family Medicine Brown University Health Services, Brown University, 13 Brown Street, Providence, RI 02912-0001 2006-11-20
1881781920 Arthur A Frazzano Family Medicine 97 Waterman St, Providence, RI 02912-9079 2006-10-09
1871609842 Wayne C Cole Family Medicine 121 East Main St, Providence, KY 42450 2006-08-22
1629181268 David J Coia Family Medicine 235 Plain St Ste 103, Providence, RI 02905-3242 2006-08-17
1326151937 Solmaz Behtash Family Medicine 712 Broad St, Providence, RI 02907-1465 2006-08-16
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City PROVIDENCE
Zip Code 84332

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Dataset Information

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.

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