BENJAMIN W BLACKBURN (NPI# 1649380049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649380049 |
| Entity Type | Individual |
| Full Name | BENJAMIN W BLACKBURN |
| Credential | PA-C |
| Practice Address |
8849 S Redwood Rd Ste E-121 West Jordan UT 84088-5619 |
| Mailing Address |
Po Box 95970 South Jordan UT 84095-0970 |
| Practice Telephone | 8015691999 |
| Practice Fax Number | 8015692001 |
| Mailing Telephone | 8013529500 |
| Mailing Fax Number | 8013529502 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2015-10-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 8983610-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 3458 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679763684 | Benjamin Allan Blackburn IIi | Dentist | 75 Piedmont Ave Ne Ste 400, Atlanta, GA 30303-2509 | 2007-07-26 |
| 1609073758 | Benjamin Allen Blackburn II | Dentist | 2812 Piedmont Rd Ne, Suite 400, Atlanta, GA 30305-2779 | 2007-07-02 |
| Street Address |
8849 S REDWOOD RD STE E-121 |
| City | WEST JORDAN |
| State | UT |
| Zip Code | 84088-5619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881178655 | Sierra Burt | Physician Assistant | 3584 West 90000 South Suite 304, West Jordan, UT 84088 | 2018-09-18 |
| 1659861847 | Miller Anesthesia Consultants PC | Anesthesiology | Jvmc Dept. of Anesthesiology, 3580 W. 9000 S., West Jordan, UT 84088 | 2018-05-14 |
| 1821501495 | Cleo Stephanides Cheney | Dentist | 8846 South Redwood Rd., Suite N201, West Jordan, UT 84088 | 2017-11-06 |
| 1124546742 | Crystal Lynn Santos | Counselor | 4431 8200 S, West Jordan, UT 84088 | 2017-09-04 |
| 1154705960 | Heston Farnsworth | Dentist | 9217 South Redwood Road, Suite B, West Jordan, UT 84088 | 2015-07-13 |
| 1750778767 | Andrew Cantwell | Dentist | 3855 7800 South #150, West Jordan, UT 84088 | 2015-04-17 |
| 1962764282 | Steven Howard Reano | Specialist | 8789 S Redwood Road, Ste 100, West Jordan, UT 84088 | 2012-06-12 |
| 1528328846 | Orthodontic Payment Services, LLC | Dentist | 1231 W 9000 S #d, West Jordan, UT 84088 | 2012-05-21 |
| 1588932321 | Jessica Millard | Counselor | 9278 S 1700 W, West Jordan, UT 84088 | 2011-12-08 |
| 1346553062 | Barbara Rouse | Counselor | 9278 Redwood Rd, West Jordan, UT 84088 | 2010-07-22 |
| Find all providers in zip 84088 | ||||
| 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 |
|---|---|---|---|---|
| 1588204705 | Cherokee Cricket Carrillo | Physician Assistant | 8605 S Shulsen Ln, West Jordan, UT 84088-9307 | 2020-01-15 |
| 1235787870 | Altium Health LLC | Physician Assistant | 7613 S Jordan Landing Blvd Ste 200, West Jordan, UT 84084-1973 | 2019-08-27 |
| 1063974111 | Amelia Allmark | Physician Assistant | 3592 W 9000 S Ste 200, West Jordan, UT 84088-8819 | 2019-04-05 |
| 1528533775 | Karen Bohn | Physician Assistant | 3590 W 9000 S Ste 120, West Jordan, UT 84088-8858 | 2018-10-03 |
| 1881178655 | Sierra Burt | Physician Assistant | 3584 West 90000 South Suite 304, West Jordan, UT 84088 | 2018-09-18 |
| 1396757241 | Jared P Spackman | Physician Assistant | 8822 South Redwood Road, C-211, West Jordan, UT 84088-8811 | 2006-08-12 |
| 1053327312 | Janis K Cline | Physician Assistant | 3584 W. 9000 S., Suite 311, West Jordan, UT 84088-4775 | 2006-07-31 |
| 1629038716 | Duane A Bates | Physician Assistant | 8822 S Redwood Rd, Suite E122, West Jordan, UT 84088-9336 | 2006-03-24 |
| 1629077870 | Corey L Newman | Physician Assistant | 7611 S Jordan Landing Blvd, Suite 200, West Jordan, UT 84084-5610 | 2005-07-19 |
| 1508414012 | Alyson Oblock | Physician Assistant | 3580 W 9000 S, West Jordan, UT 84088-8812 | 2019-08-28 |
| Find all providers in WEST JORDAN | ||||
| City | WEST JORDAN |
| Zip Code | 84088 |
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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.