MR. SHAUN MICKELSEN


Address: 2121 N 1700 W, Layton, UT 84041-8803
Phone: 8017734840

MR. SHAUN MICKELSEN (NPI# 1871945618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1871945618
Entity Type Individual
Full Name MR. SHAUN MICKELSEN
Credential PA-C
Practice Address 2121 N 1700 W
Layton
UT 84041-8803
Mailing Address Po Box 337
Layton
UT 84041-0337
Practice Telephone 8017734840
Mailing Telephone 8017734840
Mailing Fax Number 8015258151
Enumeration Date 2016-07-05
Last Update Date 2016-10-06
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
363AM0700X UT Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 2121 N 1700 W
City LAYTON
State UT
Zip Code 84041-8803

Providers in the same location

NPI Name Taxonomy Address Enumeration
1003808122 Khaldoun M Al-rayess Internal Medicine 2121 N 1700 W, Layton, UT 84041-8803 2005-08-16
1306443940 Jodi Mansfield Counselor 2121 N 1700 W, Layton, UT 84041-8803 2020-10-07
1639780745 Darren Strong Physician Assistant 2121 N 1700 W, Layton, UT 84041-8803 2020-08-12
1710545603 Ann-kristin Swahn Nurse Practitioner 2121 N 1700 W, Layton, UT 84041-8803 2019-06-05
1386209641 Rachael Gardner Dietitian, Registered 2121 N 1700 W, Layton, UT 84041-8803 2019-05-02
1346704418 Cindy Johnston Registered Nurse 2121 N 1700 W, Layton, UT 84041-8803 2019-01-23
1003388265 Aaron Joseph Reich Physician Assistant 2121 N 1700 W, Layton, UT 84041-8803 2018-12-27
1588136485 Eleanore Debbie Weese Nurse Practitioner 2121 N 1700 W, Layton, UT 84041-8803 2018-12-18
1124593942 Eric Marvin Carl Monfrooy Physician Assistant 2121 N 1700 W, Layton, UT 84041-8803 2018-10-08
1346725678 Marcus Chavez Physician Assistant 2121 N 1700 W, Layton, UT 84041-8803 2018-10-02
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1700499183 Grab Healthcare, LLC Clinic/Center 245 E 2150 N, Suite C, Layton, UT 84041 2020-08-26
1154961399 Victoria Leeann Taylor Massage Therapist 716 Antelope Dr, Layton, UT 84041 2020-01-15
1184181505 Brian Taylor Woodbury Occupational Therapist 471 Heritage Park Blvd. Ste #5, Layton, UT 84041 2019-02-21
1740756816 Jacob C Juarez Physician Assistant 2084 N. 1700 W., Suite A, Layton, UT 84041 2018-10-16
1134637945 Jodi Lynn Siri Counselor 365 W 1550 N Ste F, Layton, UT 84041 2018-01-15
1083128029 Utah Cvs Pharmacy LLC Pharmacy 50 South Fort Lane, Layton, UT 84041 2017-11-29
1376057315 Utah Cvs Pharmacy, L.L.C. Durable Medical Equipment & Medical Supplies 2000 W & W 1700 S Nec, Layton, UT 84041 2017-11-29
1912411992 Live Strong House LLC Counselor 377 N. Marshall Way, Suite 1b, Layton, UT 84041 2017-11-28
1003326505 Kenneth L Ernstrom Pharmacist 2065 N Robins Drive, Layton, UT 84041 2017-10-10
1356868319 Utah Home Health and Hospice LLC Family Medicine 920 W Heritage Park Blvd Suite 120, Layton, UT 84041 2017-08-29
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1063430890 Brad Rodney Larsen Physician Assistant 2950 N Church St, Ste 200, Layton, UT 84040-6504 2006-07-18
1366819575 Val Duane Warner Physician Assistant 2121 N 1700 W, Layton, UT 84041-8803 2015-08-24
1417267956 Kurt R Umbrell Physician Assistant 2132 N 1700 W, Suite 200, Layton, UT 84041-7057 2010-10-18
1902967219 Roderick D Maxwell Physician Assistant 2084 N 1700 W, Suite A, Layton, UT 84041 2006-12-12
1831175272 Robert Bunnell Physician Assistant 2084 N 1700 W, Suite A, Layton, UT 84041 2005-12-19
1295710960 Ronald Scott Bingham Physician Assistant 1580 W Antelope Dr, Suite 100, Layton, UT 84041-1160 2005-12-14
1467440701 Mont C Robins Physician Assistant 124 S Fairfield Rd, Layton, UT 84041-7105 2005-10-11

Providers in the same taxonomy and state

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
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Competitor

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City LAYTON
Zip Code 84041

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Dataset Information

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.

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