Gary Earl Brundage

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8666499-3501 Issued in UT

Practice address

5640 S 3500 W
Roy, UT 84067-9158

Phone

(017) 732-8388

Fax

(801) 773-3025

NPI assigned

Aug 12, 2010

Last updated

Jul 29, 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Elements of Motivation LLC

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1457644023
  NPD
• Therapy Today Behavioral Health LLC

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1306200845
  NPD
• Trillity Care Counseling LLC

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1487101549
  NPD
• Claudia Barraza

  • Health Maintenance Organization
  • Las Vegas, NV
  • NPI 1508108549
  NPD (past)

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1861707036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 HISLOP DR",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844046809",
            "telephone_number": "801-814-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5640 S 3500 W",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840679158",
            "telephone_number": "017-732-8388",
            "fax_number": "801-773-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNDAGE",
        "first_name": "GARY",
        "middle_name": "EARL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-12",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "7435-C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "8666499-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henry Brower
• Haiden Brown-Lassig
• Gerald H. Brown, DDS
• Joshua Brown, DPT
• Kallie Kay Brown, DOULA
• Renee Lee Brunner -Houser, MSN, PMHNP-BC, RN
• Misty Burnett
• Jordan Burningham, SUDC
• Joshua Burningham
• Jeremy Kim Burtenshaw, PHARM.D.

• Clinical Social Worker in Roy, UT
• Providers in Roy, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.