Active NPI
Todd Hamblin
- Family Nurse Practitioner
- Logan, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 5554739-4405
- Practice address
- 1350 N 500 E
Logan, UT 84341-2400 - Phone
- (435) 716-1130
- Fax
- (435) 719-1131
- NPI assigned
- Nov 9, 2011
- Last updated
- Mar 17, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5554739-4405 | UT | Primary |
Addresses
Primary practice location
1350 N 500 E
Logan, UT 84341-2400
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Phone (435) 716-1130
Other practice location 1
1055 N 500 W
Suite 202
Provo, UT 84604-3305
Phone (801) 374-2367
Other practice location 2
1350 N 500 E
Logan, UT 84341-2400
Phone (435) 716-1130
Other practice location 3
1055 N 500 W
Suite 202
Provo, UT 84604-3305
Phone (801) 374-2367
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT, ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Ihc Health Services Inc
Practice addresses (Care Compare)
1034 N 500
Uvh Phys Billing
Provo, UT 84604-3380
Phone (801) 357-7850
1350 N 500
Logan, UT 84341-2400
Phone (435) 716-1770
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5554739-4405 | UT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Molina Care Connections, LLC. | Current | Accepting new patients | |
| Molina Healthcare of Utah Inc | Family | Current | Accepting new patients |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Past | Accepting new patients |
Locations
200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666
950 W Bannock St
Ste 1100
Boise, ID 83702
Phone (201) 293-7689
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
201 W Layton Pkwy
Ste 2A
Layton, UT 84041
Phone (801) 387-7185
1281 N 600 E
Logan, UT 84341
Phone (435) 716-6400
7050 S Union Park Ave
Ste 200
Midvale, UT 84047
Phone (562) 549-3966
1350 N 500 E
North Logan, UT 84341
Phone (435) 716-2800
4403 Harrison Blvd
Ste 1670
Ogden, UT 84403
Phone (801) 387-7125
1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119
400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080
Interoperability endpoints
- https://epicproxy.et1057.epichosted.com/FHIRProxy/api/FHIR/R4/
Organizations & group practices 8
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba IMED Physicians Billing
- Multi-Specialty Clinic/Center
- Murray, UT
- NPI 1629260880
-
- Multi-Specialty Clinic/Center
- Sandy, UT
- NPI 1942325154
-
- Family Nurse Practitioner
- Midvale, UT
- NPI 1619486396
-
dba IMED Utah Heart - LDSH
- Multi-Specialty Clinic/Center
- Salt Lake City, UT
- NPI 1235363094
-
dba Cottonwood Medical Clinic - Infusion
- Rheumatology Physician
- Murray, UT
- NPI 1346634342
-
dba St George Adolescent Partial Hospitalization
- Psychiatry Physician
- St George, UT
- NPI 1023843844
-
dba Orem Community Hospital Physicians
- Multi-Specialty Clinic/Center
- Orem, UT
- NPI 1588601124
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Intermountain Health McKay-Dee Hospital
- General Acute Care Hospital
- Ogden, UT
- NPI 1194749580
-
dba Intermountain Health Bear River Valley Hospital
- General Acute Care Hospital
- Tremonton, UT
- NPI 1679582944
-
dba Intermountain Health Logan Regional Hospital
- General Acute Care Hospital
- Logan, UT
- NPI 1831108497
-
- Critical Access Hospital
- Montpelier, ID
- NPI 1336125533
-
dba FCMC Specialty Clinic
- Critical Access Hospital
- Preston, ID
- NPI 1548355811
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1093092678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27128",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841270128",
"telephone_number": "435-716-1130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 N 500 E",
"city": "LOGAN",
"state": "UT",
"postal_code": "843412400",
"telephone_number": "435-716-1130",
"fax_number": "435-719-1131"
}
],
"practiceLocations": [
{
"address_1": "1055 N 500 W",
"address_2": "Suite 202",
"address_purpose": "LOCATION",
"city": "Provo",
"state": "UT",
"postal_code": "846043305",
"country_code": "US",
"telephone_number": "801-374-2367",
"fax_number": "801-429-8015",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1350 N 500 E",
"address_purpose": "LOCATION",
"city": "Logan",
"state": "UT",
"postal_code": "843412400",
"country_code": "US",
"telephone_number": "435-716-1130",
"fax_number": "435-719-1131",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1055 N 500 W",
"address_2": "Suite 202",
"address_purpose": "LOCATION",
"city": "Provo",
"state": "UT",
"postal_code": "846043305",
"country_code": "US",
"telephone_number": "801-374-2367",
"fax_number": "801-429-8015",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HAMBLIN",
"first_name": "TODD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-09",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "UT",
"license": "5554739-4405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.