JOHN A WHITEHEAD (NPI# 1619935053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619935053 |
| Entity Type | Individual |
| Full Name | JOHN A WHITEHEAD |
| Credential | PA |
| Practice Address |
1055 N 500 W Suite 101 Provo UT 84604-3305 |
| Mailing Address |
1055 N 500 W Provo UT 84604-3305 |
| Practice Telephone | 8013734366 |
| Practice Fax Number | 8014298191 |
| Mailing Telephone | 8013548225 |
| Mailing Fax Number | 8014298180 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2007-10-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 3694731206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | UPIN | S70943 | 01 |
| UT | 870281028000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265760334 | John R Whitehead | Chiropractor | 11488 Open View Ln, South Jordan, UT 84095-8790 | 2009-11-30 |
| 1891866679 | John J Whitehead | Ophthalmology | 1229 Madison St Ste 1250, Seattle, WA 98104-3568 | 2006-11-13 |
| 1265431860 | John R Whitehead | Emergency Medicine | 2610 N Woodlawn Blvd, Wichita, KS 67220-2729 | 2005-07-18 |
| 1336583863 | John L Whitehead | Psychologist | 2910 E Madison St, Suite 305, Seattle, WA 98112-4214 | 2013-04-26 |
| 1669768917 | John Wayne Whitehead | Pharmacist | 1591 Bradley Park Dr, T-1179, Columbus, GA 31904-3071 | 2011-06-24 |
| 1093949414 | John James Whitehead | Dentist | 3162 Newberry Dr, San Jose, CA 95118-1500 | 2009-05-13 |
| 1275772295 | John Louis Whitehead | Surgery | 1111 Kane Concourse Ste 311, Bay Harbor Islands, FL 33154-2041 | 2009-02-14 |
| Street Address |
1055 N 500 W SUITE 101 |
| City | PROVO |
| State | UT |
| Zip Code | 84604-3305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144223835 | Bruce C Mcallister | Specialist | 1055 N 500 W, Suite 102, Provo, UT 84604-3305 | 2005-05-27 |
| 1922641448 | Lilian Silva Dana | Nurse Practitioner | 1055 N 500 W, Suite. 222, Bldg. C, Provo, UT 84604 | 2019-10-28 |
| 1407373574 | Kristie Christensen | Nurse Practitioner | 1055 N 500 W, Ste 101, Bldg C, Provo, UT 84604-3305 | 2017-08-29 |
| 1942664867 | Holly Ann Bishop Michaels | Dietitian, Registered | 1055 N 500 W, Attn. Credentialing, Provo, UT 84604-3305 | 2016-04-06 |
| 1841650967 | Maile Yuzon | Physician Assistant | 1055 N 500 W, Ste 212, Provo, UT 84604-3305 | 2016-03-02 |
| 1497127658 | Kayla Hamrick Lussier | Nurse Practitioner | 1055 N 500 W, Suite 212, Provo, UT 84604-3305 | 2015-10-28 |
| 1962873281 | Ryan Francis | Nurse Practitioner | 1055 N 500 W, Ste 121, Provo, UT 84604-3305 | 2015-10-13 |
| 1083082283 | Leslee Ronald Adams | Registered Nurse | 1055 N 500 W, Ste 211, Provo, UT 84604-3305 | 2015-09-04 |
| 1750763629 | Cydne Suzannah Baird Evans | Physician Assistant | 1055 N 500 W, Ste 100, Provo, UT 84604-3305 | 2015-06-26 |
| 1073903720 | Rosanne Johnson Oliver | Nurse Practitioner | 1055 N 500 W, Ste 205, Provo, UT 84604-3305 | 2015-02-03 |
| Find all providers in the same location | ||||
| 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 | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164049201 | Makenzie Bishop | Physician Assistant | 1077 S 810 E, Provo, UT 84606-6390 | 2020-07-05 |
| 1821643974 | Michael Riding | Physician Assistant | 781 N 1100 E, Provo, UT 84606-2054 | 2019-08-06 |
| 1871147306 | Heather Robson Dunford | Physician Assistant | 1055 N 500 W # 100, Provo, UT 84604-3305 | 2019-08-01 |
| 1730741414 | Griffith Jones | Physician Assistant | 94 S 700 E, Provo, UT 84606-4912 | 2019-07-02 |
| 1770091241 | Scott Schultz | Physician Assistant | 1055 N 500 W Ste 121, Building C, Provo, UT 86404 | 2018-01-17 |
| 1881106359 | Kathryn R. Lovell | Physician Assistant | 465 N 300 W Apt 22, Provo, UT 84601-2797 | 2017-10-24 |
| 1558766014 | Nancy Huber | Physician Assistant | Mountainland Community Health Center, 529 South State Street, Provo, UT 84606 | 2014-10-27 |
| 1386980597 | Preston Gray | Physician Assistant | 2230 North University Parkway #1a, Provo, UT 84604 | 2012-12-14 |
| 1093088445 | Laurie Melissa Centeno | Physician Assistant | 1157 N 300 W Ste 201, Provo, UT 84604-6124 | 2012-02-15 |
| 1982881181 | Darron Terry Smith | Physician Assistant | 191 N 900 E, Provo, UT 84606-3537 | 2008-01-30 |
| Find all providers in PROVO | ||||
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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.