MR. RICHARD L MITTAN (NPI# 1215446919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215446919 |
| Entity Type | Individual |
| Full Name | MR. RICHARD L MITTAN |
| Credential | PA-C |
| Practice Address |
65 E 6850 S Midvale UT 84047-1215 |
| Mailing Address |
773 E 11th Ave Salt Lake City UT 84103-3641 |
| Practice Telephone | 8015686700 |
| Mailing Telephone | 18019153902 |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2017-09-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
10498761-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
10498761-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
65 E 6850 S |
| City | MIDVALE |
| State | UT |
| Zip Code | 84047-1215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245831148 | Julia Marie Palmieri | Nurse Practitioner | 65 E 6850 S, Midvale, UT 84047-1215 | 2020-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649885096 | Wound Pros Utah | Durable Medical Equipment & Medical Supplies | 6975 Union Park Avenue, Suite 600, Cottonwood Heights, UT 84047 | 2020-09-12 |
| 1457965824 | Duy Danny Vo | Pharmacist | 7200 S State St, Midvale, UT 84047 | 2020-09-03 |
| 1619457314 | Tlcpo LLC | Counselor | 6975 Union Park Avenue Suite 600, Cottonwood Heights, UT 84047 | 2018-08-21 |
| 1700371606 | Heather Ivana Lawrence | Social Worker | 6856 700 E, Midvale, Ut 84047, Midvale,ut, UT 84047 | 2018-06-25 |
| 1285128942 | A&a Counseling | Counselor | 7602 S Main St, Midvale, UT 84047 | 2018-06-17 |
| 1396235339 | Hhalmid | Assisted Living Facility | 6968 S 700 E, Midvale, UT 84047 | 2018-05-15 |
| 1750879987 | Rosemarie Elaine Brinig | Counselor | 75 E. Ft. Union, C118, Midvale, UT 84047 | 2018-04-24 |
| 1861921140 | Olivia Devenport | Behavior Technician | 7434 S State Street, Midvale, UT 84047 | 2017-06-08 |
| 1376083071 | Marathon Health, LLC | Nurse Practitioner | 7259 South Bingham Junction, C/o Chg- Ut Health Center, Midvale, UT 84047 | 2017-02-28 |
| 1710436316 | Michael Naanes | Physical Therapist | 900 East 6900 South, Suite 100, Midvale, UT 84047 | 2016-09-25 |
| Find all providers in zip 84047 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922060284 | Wayne Grant Crawford | Physician Assistant | 7302 S Bingham Junction Blvd, Midvale, UT 84047-4804 | 2006-04-03 |
| 1003216508 | David Figueroa | Physician Assistant | 7495 S State St, Midvale, UT 84047-2013 | 2014-09-03 |
| 1437272820 | Constance King | Physician Assistant | 1225 Fort Union Blvd, 200, Midvale, UT 84047-1889 | 2007-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134748080 | Shannon Dhungel | Physician Assistant | 82 S 1100 E Ste 402, Salt Lake City, UT 84102-1892 | 2020-04-10 |
| 1437702875 | Jennica Marie Van Blerkom | Physician Assistant | 4755 S Wallace Ln, Holladay, UT 84117-6458 | 2019-07-23 |
| 1124599873 | Tcfh Lc | Physician Assistant | 9777 N 5520 W, Highland, UT 84003-9130 | 2018-12-06 |
| 1528533825 | Ryan Mclean Walsh | Physician Assistant | 1454 University Vlg, Salt Lake City, UT 84108-3518 | 2018-10-12 |
| 1033627351 | Linda Richards Lewis | Physician Assistant | 30 N. 1900 E, Som 5r218, Salt Lake City, UT 84132-0002 | 2018-01-22 |
| 1710416649 | Brian Adams | Physician Assistant | 1308 E 900 S # C, St George, UT 84790-8520 | 2017-06-05 |
| 1972036242 | Jace Meng | Physician Assistant | 30 N 1900 E Rm 5r218, Salt Lake City, UT 84132-0002 | 2017-04-04 |
| 1396289799 | Jefferson M Allen | Physician Assistant | 356 W 840 S, Orem, UT 84058-6778 | 2016-12-05 |
| 1609324151 | Colby Bliss | Physician Assistant | 826 N Paiute Way, Richfield, UT 84701-1849 | 2016-09-13 |
| 1154878692 | Devin Faye Petersen | Physician Assistant | 2995 E Middleton Way, Slc, UT 84124-3055 | 2016-09-01 |
| Find all providers with the same taxonomy | ||||
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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.