DR. MATTHEW M KERSHISNIK (NPI# 1851363600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851363600 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW M KERSHISNIK |
| Credential | MD |
| Practice Address |
1400 N 500 E Logan UT 84341-2455 |
| Mailing Address |
Po Box 30309 Charleston SC 29417-0309 |
| Practice Telephone | 4357165375 |
| Practice Fax Number | 8432843401 |
| Mailing Telephone | 8435549300 |
| Mailing Fax Number | 8435668780 |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2008-04-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
1831351205 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
1400 N 500 E |
| City | LOGAN |
| State | UT |
| Zip Code | 84341-2455 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376540955 | Mark D Anderson | Radiology | 1400 N 500 E, Logan, UT 84341-2455 | 2005-06-28 |
| 1790306884 | Kevin Willis Hall | Physical Medicine & Rehabilitation | 1400 N 500 E, Logan, UT 84341-2455 | 2020-04-30 |
| 1265094742 | Jacob Sanderson | Emergency Medicine | 1400 N 500 E, Logan, UT 84341-2455 | 2019-07-03 |
| 1497317523 | Adele Perry Rosenauer | Speech-Language Pathologist | 1400 N 500 E, Logan, UT 84341-2455 | 2019-06-28 |
| 1174086581 | Ridgeview Pathology LLC | Pathology | 1400 N 500 E, Logan, UT 84341-2455 | 2019-04-11 |
| 1639659543 | Angelee Hancey | Dietitian, Registered | 1400 N 500 E, Logan, UT 84341-2455 | 2018-08-20 |
| 1144736372 | Ihc Health Services Inc | Radiology | 1400 N 500 E, Logan, UT 84341-2455 | 2017-12-26 |
| 1992231534 | Laycee Mozingo | Dietitian, Registered | 1400 N 500 E, Logan, UT 84341-2455 | 2017-05-02 |
| 1568996072 | Cache Valley Pathology, LLC | Pathology | 1400 N 500 E, Logan, UT 84341-2455 | 2017-04-12 |
| 1255873352 | Karen Tibbitts Filimoehala | Speech-Language Pathologist | 1400 N 500 E, 1st Floor, Logan, UT 84341-2455 | 2016-11-07 |
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| 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 |
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| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174086581 | Ridgeview Pathology LLC | Pathology | 1400 N 500 E, Logan, UT 84341-2455 | 2019-04-11 |
| 1568996072 | Cache Valley Pathology, LLC | Pathology | 1400 N 500 E, Logan, UT 84341-2455 | 2017-04-12 |
| 1689037780 | Appalachia Pathology Consultants LLC | Pathology | 20 Hospital Dr, Logan, WV 25601-3452 | 2016-04-05 |
| 1497191860 | Mark Andrew Benedict | Pathology | 1400 N 500 E, Logan, UT 84341-2455 | 2013-05-13 |
| 1053383141 | Northern Utah Pathology PC | Pathology | 1400 N 500 E, Logan, UT 84341-2455 | 2006-02-03 |
| 1952395980 | Pathology Laboratory Medicine Consultants Inc | Pathology | 20 Hospital Dr, Logan, WV 25601-3452 | 2005-09-06 |
| 1831183862 | Alex Presbitero Racadag | Pathology | 20 Hospital Dr, Logan, WV 25601-3452 | 2005-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659746535 | Lmd Path, Inc | Pathology | 1018 S 350 E, Provo, UT 84606-6152 | 2015-12-03 |
| 1376970772 | Pathology Services of Utah | Pathology | 400 E 1600 S, Mapleton, UT 84664-5205 | 2013-09-30 |
| 1962842864 | Matthew Scott Johnson | Pathology | 2000 Circle of Hope Dr Rm N3100, Salt Lake City, UT 84112-5550 | 2013-06-25 |
| 1578852661 | Jolanta Jedrzkiewicz | Pathology | 434 2nd Ave Apt 4, Salt Lake City, UT 84103-5623 | 2011-03-30 |
| 1861714768 | Mtd Medical Services, LLC | Pathology | 290 N Red Slide Dr, Wellsville, UT 84339-9757 | 2010-02-18 |
| 1891922951 | Thomas Cary Wilson | Pathology | 5330 S 900 E Ste 120, Salt Lake City, UT 84117-3504 | 2009-06-16 |
| 1780822809 | Dana Claire Gingell | Pathology | 1372 S 300 E, Salt Lake City, UT 84115-1502 | 2009-01-27 |
| 1639315070 | Benjamin Lloyd Witt | Pathology | University of Utah 50 N Medical Dr, Department of Pathology, Salt Lake City, UT 84132-0001 | 2009-01-06 |
| 1619130036 | Jeremy Wallentine | Pathology | 2913 Garden Meadows Cv, Slc, UT 84106-1302 | 2008-07-07 |
| 1164683959 | Jessica Comstock | Pathology | 100 N Mario Cappechi Dr, Primary Childrens Medical Center Dept of Pathology, Salt Lake City, UT 84113 | 2008-06-24 |
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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.