Michael Sean Harlan, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

57954461206 Issued in UT

Practice address

4932 S 3425 W
Roy, UT 84067-8656

Phone

(801) 309-6174

NPI assigned

Aug 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Snow Canyon Clinic, Inc.

  • Multi-Specialty Clinic/Center
  • Ivins, UT
  • NPI 1235185646
  NPD (past)

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1760673115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4932 S 3425 W",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840678656",
            "telephone_number": "801-309-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4932 S 3425 W",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840678656",
            "telephone_number": "801-309-6174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARLAN",
        "first_name": "MICHAEL",
        "middle_name": "SEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "UT",
            "license": "57954461206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Hales
• Kelcie Hall
• Alexis Halladay
• Brooklyn Hamblin
• Alan Hammer
• Harmon City Inc
• Liberty Harris
• Matthew L Harris, D.D.S.
• Aaron Max Hartman, OD
• Isaac Hayes

• Surgical Physician Assistant in Roy, UT
• Providers in Roy, UT by specialty
• Surgical Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; 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.