MARTIN M SHINEDLING (NPI# 1275583296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275583296 |
| Entity Type | Individual |
| Full Name | MARTIN M SHINEDLING |
| Credential | PHD |
| Practice Address |
272 E Center St Suite 207 Ivins UT 84738-6456 |
| Practice Telephone | 4356523775 |
| Practice Fax Number | 4356528334 |
| Mailing Telephone | 4356523775 |
| Mailing Fax Number | 4356528334 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2011-05-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 6906880-2501 | UT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS | 680Z910100 | 01 |
| MI | BLUE CARE NETWORK | P25143F | 01 |
| Street Address |
272 E CENTER ST SUITE 207 |
| City | IVINS |
| State | UT |
| Zip Code | 84738-6456 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770540619 | Gary Lee Jones | Psychiatry & Neurology | 272 E Center St, Ivins, UT 84738-6456 | 2006-04-26 |
| 1568794162 | Health Force One | Family Medicine | 272 E Center St, Ivins, UT 84738-6456 | 2010-02-05 |
| 1700031473 | Mary C Freesh | Family Medicine | 272 E Center St, Suite 201, Ivins, UT 84738-6456 | 2008-11-22 |
| 1629163555 | Drew D Richards | Dentist | 272 E Center St, Ste 205, Ivins, UT 84738-6456 | 2006-10-04 |
| 1154429397 | Steven Raymond Leydsman | Dentist | 272 E Center St, Suite #205, Ivins, UT 84738-6456 | 2006-09-20 |
| 1720180599 | Adam Boyd Webb | Physical Therapist | 272 E Center St, Suite 103, Ivins, UT 84738-6456 | 2006-09-02 |
| 1871511824 | Metwest Inc | Clinical Medical Laboratory | 272 E Center St, 220, Ivins, UT 84738-6456 | 2006-07-18 |
| 1235185646 | Snow Canyon Clinic, Inc. | Clinic/Center | 272 E Center St, Ivins, UT 84738-6456 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366783466 | Avalon Care Center - Va Ivins, LLC | Skilled Nursing Facility | 160 North 200 East, Ivins, UT 84738 | 2013-03-14 |
| 1801063441 | Paiute Indian Tribe of Utah | Clinic/Center | 3705 N 6100 W, Ivins, UT 84738 | 2008-05-13 |
| 1639274574 | Mark Lee Wardle | Family Medicine | 255 E Center St, Ivins, UT 84738 | 2006-09-14 |
| 1083670459 | Raymond Jack Middleton | Family Medicine | 653 South 170 West, Ivins, UT 84738 | 2006-04-25 |
| 1447655063 | Heather Reynolds | Physician Assistant | 3705 N 6100 W, Ivins, UT 84738 | 2014-10-24 |
| 1558590539 | Paiute Indian Tribe of Utah | Prosthetic/Orthotic Supplier | 3705 N 6100 W, Ivins, UT 84738 | 2009-07-10 |
| 1316182678 | Scott Robert Moore | Massage Therapist | 565 S 250 E, Ivins, UT 84738-5010 | 2008-12-15 |
| 1700331162 | At Home Care and Health Services | In Home Supportive Care | 639 S 315 E, Ivins, UT 84738-5054 | 2016-08-16 |
| 1609315431 | At Home Care and Health Services LLC | Private Vehicle | 639 S 315 E, Ivins, UT 84738-5054 | 2017-02-13 |
| 1841515889 | Donna Alexander | Speech-Language Pathologist | 302 S 380 W, Ivins, UT 84738-5104 | 2010-04-01 |
| Find all providers in zip 84738 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780215269 | Reboot Centers Hobble Creek | Clinical Neuropsychologist | 1154 Left Fork Hobble Creek Canyon Rd, Springville, UT 84663 | 2020-02-03 |
| 1497254304 | Ctr Supports | Clinical Neuropsychologist | 10182 S Campden Ct, South Jordan, UT 84009-7109 | 2018-02-06 |
| 1770954356 | Erin Elizabeth Krauskopf | Clinical Neuropsychologist | 231 E 400 S Ste 335, Salt Lake City, UT 84111-2806 | 2015-10-08 |
| 1528469947 | Jordan Harris Rigby | Clinical Neuropsychologist | 230 S 500 E Ste 100, Salt Lake City, UT 84102-2048 | 2014-09-05 |
| 1366719601 | Joann T. Tschanz | Clinical Neuropsychologist | 2810 Old Main Hill, Utah State University, Logan, UT 84322-2810 | 2011-11-30 |
| 1649567728 | Grace Macdowell | Clinical Neuropsychologist | 11762 S State St Ste 160, Draper, UT 84020-7174 | 2011-07-08 |
| 1215239348 | Jon Leroy Pertab | Clinical Neuropsychologist | 5171 South Cottonwood St Suite 810, Neurosciences Institute, Murray, UT 84107 | 2010-11-22 |
| 1619287208 | Lisa Michelle Sugerman | Clinical Neuropsychologist | 389 W 10000 S Ste A, South Jordan, UT 84095-4104 | 2010-10-15 |
| 1154565729 | Keith Mcgoldrick | Clinical Neuropsychologist | 1733 S 1100 E Ste 102, Salt Lake City, UT 84105-3482 | 2009-04-27 |
| 1356593297 | Dustin Bradshaw Hammers | Clinical Neuropsychologist | 650 Komas Dr Ste 106a, Salt Lake City, UT 84108-1225 | 2008-10-22 |
| 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.