MR. KENNETH ALAN WADE (NPI# 1699826149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699826149 |
| Entity Type | Individual |
| Full Name | MR. KENNETH ALAN WADE |
| Credential | P.A |
| Practice Address |
1325 N 600 E Suite 102 Logan UT 84341-6738 |
| Practice Telephone | 4357539999 |
| Practice Fax Number | 4357532301 |
| Mailing Telephone | 4357539999 |
| Mailing Fax Number | 4357532301 |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2016-11-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1015921206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | STATE LICENSE | 1015921206 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851511497 | Kenneth J Wade | Counselor | 3100 Highland Ave S, Birmingham, AL 35205-1408 | 2007-04-26 |
| 1235273558 | Kenneth Wade | Anesthesiology | 367 Hospital Blvd, Jackson, TN 38305-2080 | 2007-02-19 |
| Street Address |
1325 N 600 E SUITE 102 |
| City | LOGAN |
| State | UT |
| Zip Code | 84341-6738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558351742 | Barry A Noorda | Obstetrics & Gynecology | 1325 N 600 E, 102, Logan, UT 84341-2684 | 2005-10-27 |
| 1710294004 | Marci Kae Buttars | Nurse Practitioner | 1325 N 600 E, Suite 101, Logan, UT 84341-6738 | 2010-09-08 |
| 1184803827 | Ryan R Bell | Pediatrics | 1325 N 600 E, Suite 101, Logan, UT 84341-6738 | 2007-10-30 |
| 1952599409 | Treehouse Pediatrics & Family Care LLC | Internal Medicine | 1325 N 600 E, Suite 101, Logan, UT 84341-6738 | 2007-10-10 |
| 1184785529 | Anne Sadler Blackett | Obstetrics & Gynecology | 1325 N 600 E, Suite 102, Logan, UT 84341 | 2006-12-12 |
| 1487765574 | Amy A Billings | Obstetrics & Gynecology | 1325 N 600 E, Suite 102, Logan, UT 84341-6738 | 2006-08-31 |
| 1225047996 | Bruce A O Very | Internal Medicine | 1325 N 600 E, Ste 101, Logan, UT 84341 | 2006-08-05 |
| 1457342818 | Gary K Fowers | Obstetrics & Gynecology | 1325 N 600 E, Ste 102, Logan, UT 84341-2684 | 2005-11-03 |
| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245377811 | Heather Kaye Robinson | Physician Assistant | 313 Hudgins St., Suite 200, Logan, WV 25601 | 2007-01-31 |
| 1487269080 | Sean Nicholas Wright | Physician Assistant | 630 E 1400 N Ste 150, Logan, UT 84341-2549 | 2020-09-10 |
| 1770034761 | Bradley Curtis Bybee | Physician Assistant | 500 E 1400 N, Logan, UT 84341 | 2016-10-14 |
| 1295187938 | Caitlyn Rose Jennings | Physician Assistant | 630 E 1400 N Ste 135, Logan, UT 84341-2549 | 2016-07-06 |
| 1881969475 | Rafael Modesto Rodighiero | Physician Assistant | 122 Nick Savas Dr, Logan, WV 25601-3468 | 2012-03-14 |
| 1386946838 | Brandon D Durfee | Physician Assistant | 1400 N 500 E, Logan, UT 84341-2455 | 2010-12-02 |
| 1447400734 | Elm Emergency Group Pllc | Physician Assistant | 20 Hospital Dr, Logan, WV 25601-3452 | 2008-09-24 |
| 1881876860 | Brent Pitcher | Physician Assistant | 1350 N 500 E, Logan, UT 84341-2400 | 2007-11-30 |
| 1285756825 | Marc Lawson | Physician Assistant | 1400 N 500 E, Logan, UT 84341-2455 | 2007-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134748080 | Shannon Dhungel | Physician Assistant | 82 S 1100 E Ste 402, Salt Lake City, UT 84102-1892 | 2020-04-10 |
| 1437702875 | Jennica Marie Van Blerkom | Physician Assistant | 4755 S Wallace Ln, Holladay, UT 84117-6458 | 2019-07-23 |
| 1124599873 | Tcfh Lc | Physician Assistant | 9777 N 5520 W, Highland, UT 84003-9130 | 2018-12-06 |
| 1528533825 | Ryan Mclean Walsh | Physician Assistant | 1454 University Vlg, Salt Lake City, UT 84108-3518 | 2018-10-12 |
| 1033627351 | Linda Richards Lewis | Physician Assistant | 30 N. 1900 E, Som 5r218, Salt Lake City, UT 84132-0002 | 2018-01-22 |
| 1215446919 | Richard L Mittan | Physician Assistant | 65 E 6850 S, Midvale, UT 84047-1215 | 2017-09-25 |
| 1710416649 | Brian Adams | Physician Assistant | 1308 E 900 S # C, St George, UT 84790-8520 | 2017-06-05 |
| 1972036242 | Jace Meng | Physician Assistant | 30 N 1900 E Rm 5r218, Salt Lake City, UT 84132-0002 | 2017-04-04 |
| 1396289799 | Jefferson M Allen | Physician Assistant | 356 W 840 S, Orem, UT 84058-6778 | 2016-12-05 |
| 1609324151 | Colby Bliss | Physician Assistant | 826 N Paiute Way, Richfield, UT 84701-1849 | 2016-09-13 |
| 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.