MR. BRUCE MCCLANAHAN BURNHAM (NPI# 1760695514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760695514 |
| Entity Type | Individual |
| Full Name | MR. BRUCE MCCLANAHAN BURNHAM |
| Credential | PHYSICIAN ASSISTANT |
| Practice Address |
3152 North University Ave Suite 120 Provo UT 84604 |
| Mailing Address |
11119 S Prescott Park Cir Sandy UT 84092-5098 |
| Practice Telephone | 8013752177 |
| Mailing Telephone | 8015620058 |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2013-12-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1033258906 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467495515 | Bruce Evans Burnham | Specialist | 131 New London Tpke, Glastonbury, CT 06033-2246 | 2006-06-14 |
| 1417998022 | Bruce O Burnham | Family Medicine | 1100 S Medical Dr, Mt Pleasant, UT 84647-2222 | 2006-06-08 |
| Street Address |
3152 NORTH UNIVERSITY AVE SUITE 120 |
| City | PROVO |
| State | UT |
| Zip Code | 84604 |
| 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.