JACOB MATTHEW BLACKHAM (NPI# 1154553931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154553931 |
| Entity Type | Individual |
| Full Name | JACOB MATTHEW BLACKHAM |
| Practice Address |
6982 Coyote Ridge Cir Herriman UT 84096-3534 |
| Practice Telephone | 4352620806 |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2009-08-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 7399708-1702 | UT | Pharmacy Service Providers |
| Street Address |
6982 COYOTE RIDGE CIR |
| City | HERRIMAN |
| State | UT |
| Zip Code | 84096-3534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306499249 | Abundant Dental Care, P.C. | Dentist | 5089 West 12600 South, Herriman, UT 84096 | 2019-07-19 |
| 1225563703 | Kristen Haslam | Specialist/Technologist, Other | 13947 S Newburg Dr., Herriman, UT 84096 | 2017-04-21 |
| 1770960452 | Tyler Rolland Petersen | Social Worker | 13351 S Shaunna Lane, Herriman, UT 84096 | 2015-05-01 |
| 1649687948 | Victor Clark | Assisted Living Facility | 6352 W 13100 S, Herriman, UT 84096 | 2014-07-18 |
| 1548539554 | Neck and Back Relief | Chiropractor | 12600 S. 4013 W., Suite E, Riverton, UT 84096 | 2011-12-20 |
| 1114220092 | Sharlene Christensen | Counselor | 13878 S. Ken Cv, Herriman, UT 84096 | 2010-12-14 |
| 1518156991 | Jon Christian Fairbanks | Dentist | 5532 W. Herriman Main Street, #210, Herriman, UT 84096 | 2007-10-22 |
| 1215154232 | Karen Jane Olson | Nurse Practitioner | 13400 S. 5746 W #200, Herriman, UT 84096 | 2007-04-19 |
| 1619022969 | Jeffrey T Lambert | Dentist | 5532 W. Herriman Main St., #210, Herriman, UT 84096 | 2007-01-25 |
| 1578638854 | Stevenson Pediatric Dentistry P.C. | Dentist | 4019 W. 12600 S., Suite 200, Riverton, UT 84096 | 2006-11-21 |
| Find all providers in zip 84096 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215346721 | Christina Nealson Hackett | Pharmacist | 5833 W Muirwood Dr, Herriman, UT 84096-8203 | 2014-08-08 |
| 1487879706 | Anna Lee Adams | Pharmacist | 6127 Indian Pony Way, Herriman, UT 84065-4617 | 2007-04-13 |
| 1659972933 | Andrew Jacobson | Pharmacist | 5056 W 13400 S, Herriman, UT 84096-6600 | 2020-11-04 |
| 1356952121 | Cheyenne Mauldin Cunningham | Pharmacist | 5627 W 13400 S, Herriman, UT 84096-7204 | 2020-08-13 |
| 1982245361 | Joseph Chang | Pharmacist | 5560 W 13400 S, Herriman, UT 84096-6919 | 2019-10-07 |
| 1538700034 | Aaron Beck | Pharmacist | 5560 W 13400 S, Herriman, UT 84096-6919 | 2019-10-05 |
| 1538700364 | Leon Huntsman | Pharmacist | 5560 W 13400 S, Herriman, UT 84096-6919 | 2019-10-02 |
| 1467822130 | Andre Lian | Pharmacist | 5560 W 13400 S, Herriman, UT 84096-6919 | 2015-10-06 |
| 1104108547 | Casey Hansen | Pharmacist | 5627 W 13400 S, Herriman, UT 84096-7204 | 2011-09-12 |
| 1326329475 | Patrick Slimak | Pharmacist | 5627 W 13400 S, Herriman, UT 84096-7204 | 2011-09-02 |
| Find all providers in HERRIMAN | ||||
Please comment or provide details below to improve the information on JACOB MATTHEW BLACKHAM.
| 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.