DR. BLAINE P ANDERSEN (NPI# 1538279609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538279609 |
| Entity Type | Individual |
| Full Name | DR. BLAINE P ANDERSEN |
| Credential | MD |
| Practice Address |
1300 N 500 E #260 Logan UT 84341-2408 |
| Practice Telephone | 4357533400 |
| Practice Fax Number | 4357878887 |
| Mailing Telephone | 4357533400 |
| Mailing Fax Number | 4357878887 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2016-11-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208200000X | Plastic Surgery | 1788161205 | UT | Allopathic & Osteopathic Physicians |
| Y | 2082S0105X |
Plastic Surgery Specialization: Surgery of the Hand |
1788168905 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 003052200 | 05 |
| Street Address |
1300 N 500 E #260 |
| City | LOGAN |
| State | UT |
| Zip Code | 84341-2408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043210248 | Trek Lyons | Family Medicine | 1300 N 500 E, Suite 130, Logan, UT 84341-2408 | 2005-07-28 |
| 1285277103 | Allison Ewing Saunders | Physical Therapy Assistant | 1300 N 500 E, Logan, UT 84341-2408 | 2019-10-23 |
| 1649790114 | Candace Lee Slater | Physical Therapist | 1300 N 500 E, Logan, UT 84341-2408 | 2017-06-26 |
| 1972048569 | Lindsey Hunsaker | Speech-Language Pathologist | 1300 N 500 E, Logan, UT 84341-2408 | 2017-01-05 |
| 1629510086 | Sarah Harrison | Physical Therapist | 1300 N 500 E, Logan, UT 84341-2408 | 2016-11-15 |
| 1346612983 | Jamie Mcfarland | Nurse Practitioner | 1300 N 500 E, Suite 320, Logan, UT 84341-2408 | 2015-10-22 |
| 1760864193 | Mark Tureson | Physical Therapy Assistant | 1300 N 500 E, Logan, UT 84341-2408 | 2015-06-22 |
| 1922491430 | Kaye Marie Smith | Nurse Practitioner | 1300 N 500 E, Logan, UT 84341-2408 | 2015-03-07 |
| 1467851998 | Ryan Buck | Nurse Practitioner | 1300 N 500 E, Suite 320, Logan, UT 84341-2408 | 2014-08-20 |
| 1801114459 | Ihc Health Services Inc | Internal Medicine | 1300 N 500 E, Suite 320, Logan, UT 84341-2408 | 2010-05-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538701529 | Aubrey Salmond | Registered Nurse | 500 East 1500 N, Logan, UT 84341 | 2019-10-11 |
| 1043702046 | Eye Pros of Logan LLC | Optometrist | 1475 N Main St Ste 103, Logan, UT 84341 | 2018-06-05 |
| 1275050452 | Rylie Jeanne Cook | Student in an Organized Health Care Education/Training Program | 11 Aggie Village Apt. J, Logan, UT 84341 | 2017-08-28 |
| 1093262156 | Jessica Lynn Mcgarry | Social Worker | 1040 N 130 W, Apt 100, Logan, UT 84341 | 2016-09-07 |
| 1740663566 | Paul R Gregory | Occupational Therapy Assistant | 1300 N 500 E Suite 120, Suite 120, Logan, UT 84341 | 2015-06-30 |
| 1851708846 | Bradley Budge | Optometrist | 535 E 1400 N Ste 130, Logan, UT 84341 | 2014-07-22 |
| 1386058709 | Daniel Raymond Carlson | Physician Assistant | 500 E. 1400 N., Logan, UT 84341 | 2014-06-13 |
| 1902220239 | Work Injury Solutions Inc. | Clinic/Center | 630 E 1400 N Ste 140, Logan, UT 84341 | 2014-02-06 |
| 1750627287 | Lee Martin Williams Sr. | Counselor | 186 E. 1800 N., North Logan, UT 84341 | 2013-01-03 |
| 1669747804 | Ronald J Payne | Internal Medicine | 1726 North 1850 East, North Logan, UT 84341 | 2012-03-21 |
| Find all providers in zip 84341 | ||||
| Taxonomy Code | 2082S0105X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| Specialization | Surgery of the Hand |
| A plastic surgeon with additional training in the investigation, preservation, and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710066378 | James Raymond Fowler | Plastic Surgery | 3864 Parkview Cir, Salt Lake City, UT 84124-2319 | 2006-11-03 |
| 1841380466 | William Bradford Rockwell | Plastic Surgery | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2006-10-13 |
| 1194750711 | Daniel S. Sellers M.d. LLC | Plastic Surgery | 620 Medical Dr, Suite 310, Bountiful, UT 84010-5084 | 2006-07-12 |
| 1609818616 | Jon B Bishop | Plastic Surgery | 700 W 800 N, Suite 442, Orem, UT 84057-6301 | 2006-06-12 |
| 1841278942 | Daniel Shane Sellers | Plastic Surgery | 620 Medical Dr, Suite 310, Bountiful, UT 84010-4908 | 2006-01-09 |
| 1851377725 | York J Yates | Plastic Surgery | 2121 N 1700 W, Layton, UT 84041-8803 | 2005-12-21 |
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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.