WILLIAM R. MATHIE (NPI# 1255517488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255517488 |
| Entity Type | Individual |
| Full Name | WILLIAM R. MATHIE |
| Credential | PA |
| Practice Address |
1055 N 500 W Ste 121 Provo UT 84604-3305 |
| Mailing Address |
1055 N 500 W Attn: Credentialing Provo UT 84604-3305 |
| Practice Telephone | 8013737350 |
| Practice Fax Number | 8018125401 |
| Mailing Telephone | 8013548225 |
| Mailing Fax Number | 8014180941 |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2020-03-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
313527-8002 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 555 W State Road 164, Salem, UT 846535732 | 8013548225 | |
| 700 W 800 N Ste 100, Orem, UT 840576301 | 8013737350 | 8012245337 |
| Street Address |
1055 N 500 W STE 121 |
| City | PROVO |
| State | UT |
| Zip Code | 84604-3305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477031870 | Timothy Ross Carroll | Physician Assistant | 1055 N 500 W Ste 121, Provo, UT 84604-3305 | 2018-07-30 |
| 1053856542 | Zachary David Golden | Physician Assistant | 1055 N 500 W Ste 121, Provo, UT 84604-3305 | 2016-12-20 |
| 1205217890 | Kelsey Gleason | Physician Assistant | 1055 N 500 W Ste 121, Provo, UT 84604 | 2015-06-09 |
| 1427463330 | Todd Michael Gilbert | Orthopaedic Surgery | 1055 N 500 W Ste 121, Provo, UT 84604-3305 | 2014-06-30 |
| 1336302546 | Benjamin Steven Crouch | Physical Medicine & Rehabilitation | 1055 N 500 W Ste 121, Provo, UT 84604-3305 | 2008-07-08 |
| 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 |
| 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 |
| 1104801315 | Scott Alan Lange | Physician Assistant | 1134 N 500 W, Suite 100, Provo, UT 84604-3383 | 2005-12-09 |
| Find all providers in PROVO | ||||
Please comment or provide details below to improve the information on WILLIAM R. MATHIE.
| 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.