Robert Bunnell, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

104662-1206 Issued in UT

Practice address

2084 N 1700 W
Suite a
Layton, UT 84041

Phone

(801) 773-8644

Fax

(801) 773-9828

NPI assigned

Dec 19, 2005

Last updated

Apr 23, 2020By 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

Enrolled in UT

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.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Family MedicalGroup PAC ID 7416197785, 84 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Community Health Centers, Inc.

  dba 72nd Street Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Midvale, UT
  • NPI 1073611364

  Corporate Officer

  CMS ownership
• Community Health Centers, Inc.

  dba Neighborhood Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Salt Lake City, UT
  • NPI 1255757670

  Corporate Director

  CMS ownership
• Community Health Centers, Inc.

  dba Central City Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Salt Lake City, UT
  • NPI 1316421761

  Corporate Director

  CMS ownership
• Community Health Centers, Inc.

  dba Ellis R. Ship Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • West Valley City, UT
  • NPI 1326417445

  Corporate Director

  CMS ownership
• Community Health Centers, Inc.

  dba Stephen D. Ratcliffe Medical & Dental Clinic

  • Federally Qualified Health Center (FQHC)
  • Salt Lake City, UT
  • NPI 1538267828

  Corporate Director

  CMS ownership
• Community Health Centers, Inc.

  dba Oquirrh View Medical & Dental Clinic

  • Federally Qualified Health Center (FQHC)
  • Taylorsville, UT
  • NPI 1801992953

  Corporate Officer

  CMS ownership

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.

• Premier Family Medical

  • Family Medicine Physician
  • Pleasant Grove, UT
  • NPI 1750725735
  Medicare reassignment Care Compare group NPD (past)
• Premier Family Medical - City Center

  • Family Medicine Physician
  • Eagle Mountain, UT
  • NPI 1649160235
  NPD
• Premier Family Medical - Lindon

  • Family Medicine Physician
  • Lindon, UT
  • NPI 1427492305
  NPD
• Families First Pediatrics

  dba Wee Care Pediatrics

  • Pediatrics Physician
  • Kaysville, UT
  • NPI 1669424099
  NPD (past)
• Premier Family Medical - Traverse Mountain

  • Family Medicine Physician
  • Lehi, UT
  • NPI 1003202730
  NPD (past)

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1831175272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1159 E 200 N STE 100",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032053",
            "telephone_number": "801-553-8408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2084 N 1700 W",
            "address_2": "SUITE A",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "84041",
            "telephone_number": "801-773-8644",
            "fax_number": "801-773-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNNELL",
        "first_name": "ROBERT",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "104662-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candace Romaine Bull, PHARM D
• McKenna Lyn Bull, LCSW
• Joshua Bulloch, DPT
• Jerry Jay Bullough, D.C.
• Jennifer Peck Bunker, PA-C
• Rebecca M Burgert, LCSW
• Maria Burgess, LCSW
• Tamora S Burgess, A.A.S, LMT
• Peter Burgoyne
• Ellie Burkhardt

• Medical Physician Assistant in Layton, UT
• Providers in Layton, UT by specialty
• Medical Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.

Verify at the official NPI Registry.