DR. BRYAN B BUSHMAN (NPI# 1831346170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831346170 |
| Entity Type | Individual |
| Full Name | DR. BRYAN B BUSHMAN |
| Credential | PHD |
| Practice Address |
5030 Harrison Blvd Ogden UT 84403-4311 |
| Mailing Address |
Po Box 27128 Salt Lake City UT 84127-0128 |
| Practice Telephone | 8013875600 |
| Mailing Telephone | 8013875600 |
| Mailing Fax Number | 8014751621 |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2012-12-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
5842642-2501 | UT | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers |
| Street Address |
5030 HARRISON BLVD |
| City | OGDEN |
| State | UT |
| Zip Code | 84403-4311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588660773 | Lee W Bradshaw | Clinical Nurse Specialist | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2005-06-22 |
| 1437400447 | Jonathan Ahern | Psychologist | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2012-10-01 |
| 1497039523 | Tyson John Miller | Social Worker | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2011-10-07 |
| 1598052375 | Sarah Hoffman | Nurse Practitioner | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2011-06-30 |
| 1760788160 | Bart Steven Sanders | Nurse Practitioner | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2011-02-01 |
| 1346568318 | Julie Goudie-nice | Psychologist | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2010-05-14 |
| 1497990550 | Gary V Broadbent | Social Worker | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2008-12-03 |
| 1720264369 | Marie Woodfield | Nurse Practitioner | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2008-01-14 |
| 1376731083 | Craig French | Social Worker | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2007-10-09 |
| 1154512937 | Ben W. Holt | Psychiatry & Neurology | 5030 Harrison Blvd, Behavioral Health Institute, Ogden, UT 84403-4311 | 2007-08-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235744632 | Megan Louise Larkins | Specialist/Technologist | 4000 Brinker Ave. The Apartments., Apartment 15, Ogden, UT 84403 | 2020-09-11 |
| 1154959062 | Joshua Clifford Hansen | Student in an Organized Health Care Education/Training Program | 4403 Harrison Boulevard, Ste A700, Ogden, UT 84403 | 2020-03-28 |
| 1346895935 | Positional Release Therapy Institute LLC | Specialist/Technologist | 1702 E. 5600 S., Ogden, UT 84403 | 2019-08-09 |
| 1841842077 | Braken Wooden | Chiropractor | 1893 Skyline Dr., Suite 204, South Ogden, UT 84403 | 2019-07-09 |
| 1023670569 | Wasatch Advanced Dental Care LLC | Dentist | 3590 Harrison Blvd Suite #1, Ogden, UT 84403 | 2019-07-05 |
| 1194237636 | Marci Niemeyer | Physician Assistant | 5929 Fashion Point Dr Ste 101, South Ogden, UT 84403 | 2017-10-24 |
| 1578081949 | Stephanie Jensen | Specialist/Technologist | 1473 36th Street, Ogden, UT 84403 | 2017-09-06 |
| 1891213385 | Forrest Sutherland | Specialist/Technologist | 1075 E 41st St., Ogden, UT 84403 | 2017-09-05 |
| 1184159022 | Nicole Lee Van Tassell | In Home Supportive Care | 1496 East 5600 South, Unit 6, Ogden, UT 84403 | 2017-04-28 |
| 1265889166 | Modern Dental Professionals Ut, PC | Dentist | 5974 S. Fashion Pointe Drive, Suite 210, South Ogden, UT 84403 | 2016-05-20 |
| Find all providers in zip 84403 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508318031 | Beverly Nielsen | Psychologist | 1001 Lakeview Drive, Bountiful, UT 84010 | 2016-11-01 |
| 1477913762 | Lisa Daniels | Psychologist | 4568 S Highland Dr Ste 260b, Salt Lake City, UT 84117-4236 | 2016-02-29 |
| 1609146091 | Parents Helping Parents | Psychologist | 11175 S Redwood Road, South Jordan, UT 84095-8208 | 2012-01-03 |
| 1356620264 | Tara Sharifan | Psychologist | 505 S Main St Ste 209, Bountiful, UT 84010-6398 | 2011-08-09 |
| 1386945566 | Annie Michol Deming | Psychologist | 5770 S 1500 W # G, Salt Lake City, UT 84123-5216 | 2010-11-04 |
| 1932421161 | Quinten J. Harvey | Psychologist | 4164 Open Crest Dr, South Jordan, UT 84095-7701 | 2010-02-15 |
| 1588829634 | Carla J Reyes | Psychologist | 4568 S Highland Dr Ste 100, Salt Lake City, UT 84117-4234 | 2008-07-28 |
| 1588871321 | Corinna Anne Porter | Psychologist | 90 West 200 South, Suite 2, Heber City, UT 84032 | 2007-05-17 |
| 1871640953 | Jared Scott Warren | Psychologist | 1190 North 900 East, 291 John Taylor Building, Byu, Provo, UT 84602-8626 | 2007-01-04 |
| 1265592083 | Fenster Corp. | Psychologist | 4505 Wasatch Blvd Ste 380, Salt Lake City, UT 84124-4733 | 2006-12-11 |
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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.