Individual provider Active NPI

Paul Vernal Schlaich, PA-C

  • Physician Assistant
  • Ogden, UT
National Provider Identifier
1356355986
Registry record updated Jan 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
369118-1206 Issued in UT
Practice address
4403 Harrison Blvd
Suite 1815
Ogden, UT 84403-3271
Phone
(801) 387-6520
Fax
(801) 387-6525
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 369118-1206 UT Primary
Surgical Physician Assistant 363AS0400X 369118-8906 UT

Addresses

Primary practice location

4403 Harrison Blvd
Suite 1815
Ogden, UT 84403-3271

Mailing address

4403 Harrison Blvd
Suite 1815
Ogden, UT 84403-3271
Phone (801) 387-6520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
992AKMDDentist
369118-1206UTMDPhysician Assistant
369118-8906UTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bryson S. Smith, MD, PC Past Accepting new patients
Anchorage Fracture and Orthopaedic Clinic, PC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294963200000",
    "number": "1356355986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD",
            "address_2": "SUITE 1815",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033271",
            "telephone_number": "801-387-6520",
            "fax_number": "801-387-6525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD",
            "address_2": "SUITE 1815",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033271",
            "telephone_number": "801-387-6520",
            "fax_number": "801-387-6525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLAICH",
        "first_name": "PAUL",
        "middle_name": "VERNAL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2011-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "369118-1206",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "UT",
            "license": "369118-8906",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.