KIRK RUSSELL OVERDIEK (NPI# 1619160041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619160041 |
| Entity Type | Individual |
| Full Name | KIRK RUSSELL OVERDIEK |
| Credential | APRN |
| Practice Address |
2084 N 1700 W Suite A Layton UT 84041 |
| Mailing Address |
2086 N 1700 W Suite C Layton UT 84041 |
| Practice Telephone | 8017738644 |
| Practice Fax Number | 8017739828 |
| Mailing Telephone | 8017738644 |
| Mailing Fax Number | 8019271591 |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2012-09-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
51153924405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2084 N 1700 W SUITE A |
| City | LAYTON |
| State | UT |
| Zip Code | 84041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275530156 | Brad Pace | General Practice | 2084 N 1700 W, Suite A, Layton, UT 84041 | 2005-07-07 |
| 1477090108 | American Current Care Pa | Clinic/Center | 2084 N 1700 W, Suite D, Layton, UT 84041-1100 | 2017-01-19 |
| 1811432230 | Occuaptional Health Centers of The Southwest, P.a. | Clinic/Center | 2084 N 1700 W, Suite D, Layton, UT 84041-1100 | 2016-12-20 |
| 1194106625 | Colton Lee Ragsdale | Pediatrics | 2084 N 1700 W, Suite A, Layton, UT 84041 | 2015-06-10 |
| 1821286923 | Emily Ostarcevic | Nurse Practitioner | 2084 N 1700 W, Suite A, Layton, UT 84041-1100 | 2007-10-15 |
| 1902967219 | Roderick D Maxwell | Physician Assistant | 2084 N 1700 W, Suite A, Layton, UT 84041 | 2006-12-12 |
| 1750346599 | Priscilla Aye Chen | Pediatrics | 2084 N 1700 W, Suite A, Layton, UT 84041 | 2006-04-17 |
| 1225098510 | Rocksan Moss | Physician Assistant | 2084 N 1700 W, Suite A, Layton, UT 84041-1100 | 2006-03-23 |
| 1043281918 | Robert J Anderson | Registered Nurse | 2084 N 1700 W, Layton, UT 84041-1100 | 2006-01-30 |
| 1164402202 | Jennifer M Gilsoul | Pediatrics | 2084 N 1700 W, Suite A, Layton, UT 84041 | 2006-01-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700499183 | Grab Healthcare, LLC | Clinic/Center | 245 E 2150 N, Suite C, Layton, UT 84041 | 2020-08-26 |
| 1154961399 | Victoria Leeann Taylor | Massage Therapist | 716 Antelope Dr, Layton, UT 84041 | 2020-01-15 |
| 1184181505 | Brian Taylor Woodbury | Occupational Therapist | 471 Heritage Park Blvd. Ste #5, Layton, UT 84041 | 2019-02-21 |
| 1740756816 | Jacob C Juarez | Physician Assistant | 2084 N. 1700 W., Suite A, Layton, UT 84041 | 2018-10-16 |
| 1134637945 | Jodi Lynn Siri | Counselor | 365 W 1550 N Ste F, Layton, UT 84041 | 2018-01-15 |
| 1083128029 | Utah Cvs Pharmacy LLC | Pharmacy | 50 South Fort Lane, Layton, UT 84041 | 2017-11-29 |
| 1376057315 | Utah Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2000 W & W 1700 S Nec, Layton, UT 84041 | 2017-11-29 |
| 1912411992 | Live Strong House LLC | Counselor | 377 N. Marshall Way, Suite 1b, Layton, UT 84041 | 2017-11-28 |
| 1003326505 | Kenneth L Ernstrom | Pharmacist | 2065 N Robins Drive, Layton, UT 84041 | 2017-10-10 |
| 1356868319 | Utah Home Health and Hospice LLC | Family Medicine | 920 W Heritage Park Blvd Suite 120, Layton, UT 84041 | 2017-08-29 |
| Find all providers in zip 84041 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134769342 | Mark Roland Nickle | Nurse Practitioner | 249 S 1050 E, Layton, UT 84041-4499 | 2020-01-15 |
| 1003478801 | Jennifer C Green | Nurse Practitioner | 838 E 625 S, Layton, UT 84041-4300 | 2019-07-01 |
| 1225549793 | Tatha Marie Enz | Nurse Practitioner | 1951 N 2000 E, Layton, UT 84040-2305 | 2017-10-23 |
| 1235488917 | Kimberly Simpson | Nurse Practitioner | 124 S. Fairfield Rd, Layton, UT 84041 | 2012-09-10 |
| 1710545603 | Ann-kristin Swahn | Nurse Practitioner | 2121 N 1700 W, Layton, UT 84041-8803 | 2019-06-05 |
| 1750842381 | Catherine Kelly Pierce | Nurse Practitioner | 1660 W Antelope Dr Ste 225, Layton, UT 84041-1167 | 2019-03-27 |
| 1821559360 | Avery Weida | Nurse Practitioner | 1660 W Antelope Dr Ste 225, Layton, UT 84041-1167 | 2019-03-27 |
| 1851874184 | Emily Dawn Bankhead | Nurse Practitioner | 2084 N Robins Dr Ste A, Layton, UT 84041-1118 | 2018-09-12 |
| 1811409774 | Dana Shelton | Nurse Practitioner | 2086 N 1700 W Ste D, Layton, UT 84041-1164 | 2017-11-01 |
| 1659801389 | Andrew Cardon | Nurse Practitioner | 2075 University Park Blvd, Layton, UT 84041-1611 | 2017-06-15 |
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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.