Paul D. McOmber, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12553113-1206 Issued in UT

Practice address

517 W 100 N Ste 110
Providence, UT 84332-9826

Phone

(435) 755-6075

Fax

(435) 374-0502

NPI assigned

Jul 5, 2007

Last updated

Aug 11, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1245438944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 W 100 N STE 210",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843329826",
            "telephone_number": "435-755-6061",
            "fax_number": "435-994-8362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 W 100 N STE 110",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843329826",
            "telephone_number": "435-755-6075",
            "fax_number": "435-374-0502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 S Main St",
            "address_purpose": "LOCATION",
            "city": "Randolph",
            "state": "UT",
            "postal_code": "840647701",
            "country_code": "US",
            "telephone_number": "435-755-6061",
            "fax_number": "435-994-3806",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5 W 200 N",
            "address_purpose": "LOCATION",
            "city": "Brigham City",
            "state": "UT",
            "postal_code": "843022109",
            "country_code": "US",
            "telephone_number": "435-723-7999",
            "fax_number": "435-723-7331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 W Logan Rd",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "UT",
            "postal_code": "840287754",
            "country_code": "US",
            "telephone_number": "435-946-3660",
            "fax_number": "435-946-8215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1515 N 400 E Ste 104",
            "address_purpose": "LOCATION",
            "city": "North Logan",
            "state": "UT",
            "postal_code": "843417595",
            "country_code": "US",
            "telephone_number": "435-755-6061",
            "fax_number": "435-755-6091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCOMBER",
        "first_name": "PAUL",
        "middle_name": "D.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-05",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "12553113-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Reed McBride
• Vonda Michelle McBride, APRN
• Tyler Clark McDougal, RBT
• Jessica McEwan, RBT
• Rachel McNeil, RBT
• Sarah Grace McTaggart, RBT
• Jessica Jolley Mecklenburg, RBT
• Emma Merriam, RBT
• Emma Micheel, RBT
• Cody Brad Mickelsen, MD

• Physician Assistant in Providence, UT
• Providers in Providence, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.