BRADFORD A GALE (NPI# 1932126976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932126976 |
| Entity Type | Individual |
| Full Name | BRADFORD A GALE |
| Credential | PA |
| Practice Address |
100 Mario Capecchi Drive Salt Lake City UT 84113-1103 |
| Mailing Address |
Po Box 413033 Salt Lake City UT 84141-3033 |
| Practice Telephone | 8016625400 |
| Practice Fax Number | 8015876459 |
| Mailing Telephone | 8012133900 |
| Mailing Fax Number | 8015876459 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2012-02-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 199792-1205 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 199792-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | BCBS OF UTAH | 19979210200001 | 01 |
| UT | PALMETTO | 97009604 | 01 |
| Street Address |
100 MARIO CAPECCHI DRIVE |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84113-1103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629625488 | Renee Adele Hensiek | Physical Therapist | 100 Mario Capecchi Drive, Salt Lake City, UT 84113 | 2019-08-26 |
| 1417499666 | Jenna Aubuchon | Speech-Language Pathologist | 100 Mario Capecchi Drive, Salt Lake City, UT 84132 | 2016-11-04 |
| 1306194931 | Mari Rose Kiesling | Dentist | 100 Mario Capecchi Drive, Suite 3550, Salt Lake City, UT 84113 | 2012-08-29 |
| 1821318411 | Sarah Yukiko Asaki | Pediatrics | 100 Mario Capecchi Drive, Division of Pediatric Cardiology, Salt Lake City, UT 84113 | 2010-06-04 |
| 1730217043 | Jennifer Brooke Mercier | Audiologist | 100 Mario Capecchi Drive, Pcmc Rehab Main Campus 100 N. Mario Capecchi Dr., Salt Lake City, UT 84113 | 2007-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386111060 | Melissa Marie Dixon | Psychologist | Primary Children's Hospital Outpatient Services, 81 South Mario Capecchi Drive, Salt Lake City, UT 84113 | 2018-10-31 |
| 1366965618 | Ashley Stuart | Psychologist | 44 North Mario Capecchi Drive, Salt Lake City, UT 84113 | 2017-07-19 |
| 1487945135 | Justin C Wheeler | Pediatrics | 81 N Mario Capecchi Dr Fl 4, Salt Lake City, UT 84113 | 2011-04-29 |
| 1154612117 | Dana Boucek | Pediatrics | 100 North Mario Capecchi Dr., Primary Children's, Salt Lake City, UT 84113 | 2011-04-26 |
| 1285959502 | Anna Katherine Eyre Ermarth | Pediatrics | 81 Mario Capecchi, Salt Lake City, UT 84113 | 2010-03-30 |
| 1457682072 | Elizabeth K Cho | Nurse Practitioner | 100 North Mario Cappechi Dr., Salt Lake City, UT 84113 | 2010-01-21 |
| 1528290848 | Nancy Crandell Brown | Nurse Practitioner | 100 North Mario Cappechi Drive, Salt Lake City, UT 84113 | 2009-08-20 |
| 1679708481 | Primary Children's Medical Center | General Acute Care Hospital | 100 No. Mario Capecchi Drive, Salt Lake, UT 84113 | 2009-05-22 |
| 1467697235 | Tara Hook | Physical Therapist | 100 North Mario Capecchi Dr, Salt Lake City, UT 84113 | 2008-12-09 |
| 1144474768 | Jennifer K Workman | Pediatrics | 100 N Mario Capecchi Drive, Pediatric Crtical Care, Primary Children's Hospital, Salt Lake City, UT 84113 | 2008-11-10 |
| Find all providers in zip 84113 | ||||
| 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 |
|---|---|---|---|---|
| 1417556986 | Brittany Tran | Physician Assistant | 2733 W Redwick Ct, Salt Lake City, UT 84129-5901 | 2020-10-25 |
| 1528674975 | James Christopher Nichols | Physician Assistant | 1746 E 2100 S, Salt Lake City, UT 84106-4165 | 2020-09-21 |
| 1841826971 | David Souza | Physician Assistant | 52 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-03-20 |
| 1134751902 | Jacie Anna Mundahl | Physician Assistant | 8th Ave C St E 80, Salt Lake City, UT 84143-0001 | 2020-02-10 |
| 1336770544 | Kelsey Rae Thompson | Physician Assistant | 3809 S Parkview Dr, Salt Lake City, UT 84124-2322 | 2020-01-28 |
| 1245885458 | Adam Douglas Whitney | Physician Assistant | 1056 E Harrison Ave, Salt Lake City, UT 84105-2445 | 2019-08-05 |
| 1306498654 | Jarred J Entringer | Physician Assistant | 2725 S 700 E Apt K, Salt Lake City, UT 84106-2883 | 2019-07-16 |
| 1588216840 | Christina Thomas | Physician Assistant | 255 N 400 W Apt 5015, Salt Lake City, UT 84103-1568 | 2019-07-16 |
| 1770135022 | Evar Saelee | Physician Assistant | 2630 E Stringham Ave Apt 224a, Salt Lake City, UT 84109-3945 | 2019-07-16 |
| 1982263471 | Ashley Marten | Physician Assistant | 3610 E Cascade Way, Salt Lake City, UT 84109-2307 | 2019-06-10 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84113 |
Please comment or provide details below to improve the information on BRADFORD A GALE.
| 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.