Gary E Nelson (NPI# 1629035795, PAC ID# 0648286013) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1629035795 |
| PAC ID by PECOS | 0648286013 |
| Professional Enrollment ID | I20060223000122 |
| Full Name | Gary E Nelson |
| Organization Legal Name | STATE OF UTAH |
| Address |
150 E Ctr St 1100 Heath Clinics of Utah Provo UT 84606-3703 |
| Phone Number | 8016263670 |
| Gender | M |
| Credential | PA |
| Medical School | UNIVERSITY OF UTAH SCHOOL OF MEDICINE |
| Graduation Year | 1991 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 6800797333 |
| Number of Group Practice Members | 21 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 460001 | UTAH VALLEY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 150 E Ctr St, 1100 Heath Clinics of Utah, Provo, UT 84606-3703 | 8016263670 | STATE OF UTAH |
| Organization Legal Name | STATE OF UTAH |
| Physicians | 24 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mac J Gilbert | Psychologist, Clinical | State of Utah | 1300 E Ctr St, Utah State Hospital, Provo, UT 84606-3554 |
| Pamela R Poulsen | Nurse Practitioner | State of Utah | 895 N 900, Utah State Developement Center, American Fork, UT 84003-9183 |
| Marc E Babitz | Family Medicine | State of Utah | 150 E Ctr St, 1100 Heath Clinics of Utah, Provo, UT 84606-3703 |
| Rhonda L Lee | Physician Assistant | State of Utah | 2540 Washington Blvd, 122 Health Clinics of Utah, Ogden, UT 84401-3112 |
| John C Nelson | Family Medicine | State of Utah | 168 N 1950 W, 201 Health Clinics of Utah, Salt Lake City, UT 84114-3324 |
| Olivier M Mulyangote | Physician Assistant | State of Utah | 168 N 1950 W, 201 Health Clinics of Utah, Salt Lake City, UT 84114-3324 |
| Douglas P Benson Ii | Psychologist, Clinical | State of Utah | 1300 E Ctr St, Utah State Hospital, Provo, UT 84606-3554 |
| Margaret L Gustafson | Psychologist, Clinical | State of Utah | 1300 E Ctr St, Utah State Hospital, Provo, UT 84606-3554 |
| Julia K Chasler | Psychologist, Clinical | State of Utah | 1300 E Ctr St, Utah State Hospital, Provo, UT 84606-3554 |
| Hannah M Baczynski | Psychologist, Clinical | State of Utah | 1300 E Ctr St, Utah State Hospital, Provo, UT 84606-3554 |
| Street Address |
150 E CTR ST 1100 HEATH CLINICS OF UTAH |
| City | PROVO |
| State | UT |
| Zip | 84606-3703 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marc E Babitz | Family Medicine | State of Utah | 150 E Ctr St, 1100 Heath Clinics of Utah, Provo, UT 84606-3703 |
| Joseph K Miner | Family Medicine | State of Utah | 150 E Ctr St, 1100 Heath Clinics of Utah, Provo, UT 84606-3703 |
| Cheryl Scholes | Nurse Practitioner | State of Utah | 150 E Ctr St, 1100 Heath Clinics of Utah, Provo, UT 84606-3703 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Connie D Taylor | Nurse Practitioner | Optimal Health Family Practice Pllc | 75 S 200, Suite 100, Provo, UT 84606-3146 |
| Alyssa Dawn Vest | Nurse Practitioner | Optimal Health Family Practice Pllc | 75 S 200, Suite 100, Provo, UT 84606-3146 |
| Elizabeth Daniels | Nurse Practitioner | Optimal Health Family Practice Pllc | 75 S 200, Suite 100, Provo, UT 84606-3146 |
| Barry A Clanton | Physician Assistant | Clanton Enterprises Series LLC | 75 S 200 E, Suite 202, Provo, UT 84606-3168 |
| Nathaniel L Gay | Nurse Practitioner | Clanton Enterprises Series LLC | 75 S 200 E, Suite 202, Provo, UT 84606-3168 |
| Lawrence Paul Dunning | Clinical Psychologist | Wasatch Mental Health Services Special Service District | 1165 E 300, Provo, UT 84606-3539 |
| Heidi Busch | Clinical Social Worker | Wasatch Mental Health Services Special Service District | 1165 E 300, Provo, UT 84606-3539 |
| Elizabeth Feil | Clinical Social Worker | Wasatch Mental Health Services Special Service District | 1165 E 300, Provo, UT 84606-3539 |
| Mac J Gilbert | Psychologist, Clinical | State of Utah | 1300 E Ctr St, Utah State Hospital, Provo, UT 84606-3554 |
| Douglas P Benson Ii | Psychologist, Clinical | State of Utah | 1300 E Ctr St, Utah State Hospital, Provo, UT 84606-3554 |
| Find all physicians in zip 84606 | |||
| City | PROVO |
| Zip Code | 84606 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | PROVO + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.