Brant Wahlen Fonnesbeck

Home > Brant Wahlen Fonnesbeck

NPI Number Detailed Information

Provider Information:

Name:	Brant Wahlen Fonnesbeck
Gender:	M
Provider License Number If Given:	5953772-1204

NPI Information:

NPI:	1033156849
Entity Type (Individual or Organization):	1-ind
Enumeration Date:	6/1/2006
Last Update Date:	2/26/2008
Reputation Report:

Provider Business Mailing Address:

Address:	325 W LOGAN HWY PO BOX 328 Garden City, UT 84028
Phone Number:	4357647249
Fax Number:

Provider Business Practice Location Address:

Address:	550 E 1400 N STE K Logan, UT 84341
Phone Number:	4357556061
Fax Number:

Provider Taxonomy:

Primary:	207Q00000X
Secondary (if any):
State:	UT

Top Doctors in UT

About Brant Wahlen Fonnesbeck

Brant Wahlen Fonnesbeck ( BRANT WAHLEN FONNESBECK ) is Family Family Medicine Physician in Logan, UT. The NPI Number for Brant Wahlen Fonnesbeck is 1033156849.

The current location address for Brant Wahlen Fonnesbeck is 550 E 1400 N STE K Logan, UT 84341 and the contact number is 4357647249 and fax number is . The mailing address for Brant Wahlen Fonnesbeck is 325 W LOGAN HWY PO BOX 328 Garden City, UT 84028- 4357556061 (mailing address contact number - 4357647249).

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Provider Business Location on Map

FAQs:

What is the NPI Number for Brant Wahlen Fonnesbeck ?

Answer: The NPI Number for Brant Wahlen Fonnesbeck is 1033156849

Where is Brant Wahlen Fonnesbeck located?

Answer: Brant Wahlen Fonnesbeck is located at 550 E 1400 N STE K Logan, UT 84341.

What is the specialty for Brant Wahlen Fonnesbeck ?

Answer: The Specialty of Brant Wahlen Fonnesbeck is Family Family Medicine Physician.

Are there any online reviews for Brant Wahlen Fonnesbeck ?

Answer: Yes! Check It Now.

Are there any other health care providers in Logan, UT?

Answer: Yes, there are given below...

Medicare Physician & Other Practitioners

Information on services and procedures provided to Original Medicare (fee-for-service) Part B (Medical Insurance) beneficiaries by Brant Wahlen Fonnesbeck

Number of HCPCS	25
Number of Medicare Beneficiaries	91
Number of Services	125
Total Submitted Charge Amount	23501.06
Total Medicare Allowed Amount	10643.06
Total Medicare Payment Amount	7311.68
Total Medicare Standardized Payment Amount	7413.15
Drug Suppress Indicator	*
Number of HCPCS Associated With Drug Services
Number of Medicare Beneficiaries With Drug Services
Number of Drug Services
Total Drug Submitted Charge Amount
Total Drug Medicare Allowed Amount
Total Drug Medicare Payment Amount
Total Drug Medicare Standardized Payment Amount
Medical Suppress Indicator	#
Number of HCPCS Associated With Medical Services
Number of Medicare Beneficiaries With Medical
Number of Medical Services
Total Medical Submitted Charge Amount
Total Medical Medicare Allowed Amount
Total Medical Medicare Payment Amount
Total Medical Medicare Standardized Payment Amount
Average Age of Beneficiaries	72
Number of Beneficiaries Age Less 65	17
Number of Beneficiaries Age 65 to 74	37
Number of Beneficiaries Age 75 to 84	25
Number of Beneficiaries Age Greater 84	12
Number of Female Beneficiaries	48
Number of Male Beneficiaries	43
Number of Non-Hispanic White Beneficiaries
Number of Black or African American Beneficiaries
Number of Asian Pacific Islander Beneficiaries
Number of Hispanic Beneficiaries
Number of American Indian/Alaska Native Beneficiaries
Number of Beneficiaries With Race Not Elsewhere Classified
Number of Beneficiaries With Medicare & Medicaid Entitlement
Number of Beneficiaries With Medicare Only Entitlement
Percent (%) of Beneficiaries Identified With Atrial Fibrillation	0.12
Percent (%) of Beneficiaries Identified With Alzheimer's Disease or Dementia
Percent (%) of Beneficiaries Identified With Asthma
Percent (%) of Beneficiaries Identified With Cancer
Percent (%) of Beneficiaries Identified With Heart Failure	0.26
Percent (%) of Beneficiaries Identified With Chronic Kidney Disease	0.42
Percent (%) of Beneficiaries Identified With Chronic Obstructive Pulmonary Disease
Percent (%) of Beneficiaries Identified With Depression	0.35
Percent (%) of Beneficiaries Identified With Diabetes	0.33
Percent (%) of Beneficiaries Identified With Hyperlipidemia	0.47
Percent (%) of Beneficiaries Identified With Hypertension	0.64
Percent (%) of Beneficiaries Identified With Ischemic Heart Disease	0.33
Percent (%) of Beneficiaries Identified With Osteoporosis
Percent (%) of Beneficiaries Identified With Rheumatoid Arthritis / Osteoarthritis	0.43
Percent (%) of Beneficiaries Identified With Schizophrenia / Other Psychotic Disorders
Percent (%) of Beneficiaries Identified With Stroke
Average HCC Risk Score of Beneficiaries	1.3729

Medicare Part D Prescribers

Information on prescription drugs provided to Medicare beneficiaries enrolled in Part D (Prescription Drug Coverage), by physicians and other health care providers, aggregated by provider.

Provider Specialty Type	Family Practice
Source of Provider Specialty
Number of Medicare Part D Claims, Including Refills	129
Number of Standardized 30-Day Fills	187.53333333
Aggregate Cost Paid for All Claims	3080.32
Number of Day's Supply for All Claims	4694
Number of Medicare Beneficiaries	56
Number of Claims, Including Refills, for Beneficiaries Age 65+	115
Including Refills, for Beneficiaries Age 65+	173.53333333
Beneficiaries Age 65+	2346.54
Number of Day's Supply for All Claims for Beneficaries Age 65+	4397
Number of Medicare Beneficiaries Age 65+
Reason for Suppression of Brnd_Tot_Clms and Brnd_Tot_Drug_Cst	*
Total Claims of Brand-Name Drugs
Reason for Suppression of Gnrc_Tot_Clms and Gnrc_Tot_Drug_Cst
Total Claims of Generic Drugs, Including Refills	121
Aggregate Cost Paid for Generic Drugs	1806.27
Reason for Suppression of Othr_Tot_Clms and Othr_Tot_Drug_Cst	#
Total Claims of Other Drugs, Including Refills
Aggregate Cost Paid for Other Drugs
Reason for Suppression of MAPD_Tot_Clmsand MAPD_Tot_Drug_Cst
Number of Claims for Beneficiaries Covered by MAPD Plans	74
Aggregate Cost Paid for Claims Filled by Beneficiaries in MAPD Plans	2599.74
Reason for Suppression of PDP_Tot_Clms and PDP_Tot_Drug_Cst
Number of Claims for Beneficiaries Covered by Standalone PDP Plans	55
Aggregate Cost Paid for Claims Filled by	480.58
Reason for Suppression of LIS_Tot_Clms and LIS_Drug_Cst
Number of Claims for Beneficiaries Covered by Low-Income Subsidy	18
Aggregate Cost Paid for Claims Covered by Low-Income Subsidy	859.1
Reason for Suppression of NonLIS_Tot_Clms and NonLIS_Drug_Cst
Number of Claims for Beneficiaries Not Covered by Low-Income Subsidy	111
by Low-Income Subsidy	2221.22
Total Claims of Opioid Drugs, Including
Aggregate Cost Paid for Opioid Drugs
Opioid Claims
Opioid_Tot_Clms divided by the Tot_Clms
Total Claims of Long-Acting Opioid Drugs
Aggregate Cost Paid for Long-Acting Opioid
Number of Day's Supply of All Long-Acting
Long-Acting Opioid Claims
Opioid_LA_Tot_Clms divided by the
Total Claims of Antibiotic Drugs, Including	14
Aggregate Cost Paid for Antibiotic Drugs	152.33
Antibiotic Claims	14
Reason for Suppression of Antpsyct_GE65_Tot_Clms and Antpsyct_GE65_Tot_Drug_Cst
Including Refills, for Beneficiaries Age 65+	0
Aggregate Cost Paid for AntipsychoticDrugs for Beneficiaries Age 65+	0
Reason for Suppression of Antpsyct_GE65_Tot_Benes
Number of Medicare Beneficiaries Age 65+Filling Antipsychotic Claims
Average Age of Beneficiaries	70.75
Number of Beneficiaries Age Less Than 65
Number of Beneficiaries Age 65 to 74
Number of Beneficiaries Age 75 to 84
Number of Female Beneficiaries	29
Number of Male Beneficiaries	27
Number of Non-Hispanic White	55
Number of Black or African American
Number of Asian Pacific Islander	0
Number of Hispanic Beneficiaries	0
Number of American Indian/Alaskan NativeBeneficiaries	0
Number of Beneficiaries with Race Not
Only Entitlement
Average Hierarchical Condition Category	1.4727678571

More Providers in logan , ut

Matthew A Clissold
Anesthesiology Physician
NPI Number: 1427007293
Address: 274 N MAIN ST Logan, UT 84321 , Phone: 4357531600

Richard B Palfreyman
Anesthesiology Physician
NPI Number: 1194774711
Address: 274 N MAIN ST Logan, UT 84321 , Phone: 4357531600

Courtney R Skabelund
Anesthesiology Physician
NPI Number: 1346299948
Address: 274 N MAIN ST Logan, UT 84321 , Phone: 4357531600

Kelly W Hubbard
Dermatology Physician
NPI Number: 1871542308
Address: 274 N MAIN ST Logan, UT 84321 , Phone: 4357531600

Cache County Emergency Medical Services Authority
Land Ambulance
NPI Number: 1205886579
Address: 199 N MAIN ST Logan, UT 84321 , Phone: 4357551850

Craig Burdett
Physician Assistant
NPI Number: 1205886462
Address: 274 N MAIN ST Logan, UT 84321 , Phone: 4357531600

Peter C Daines
Anesthesiology Physician
NPI Number: 1033169198
Address: 274 N MAIN ST Logan, UT 84321 , Phone: 4357531600

Lyman B Stevens
Anesthesiology Physician
NPI Number: 1164472015
Address: 274 N MAIN ST Logan, UT 84321 , Phone: 4357531600

Jefri A Williams
Anesthesiology Physician
NPI Number: 1770533622
Address: 274 N MAIN ST Logan, UT 84321 , Phone: 4357531600

Michael L Broadbent
Anesthesiology Physician
NPI Number: 1285684050
Address: 274 N MAIN ST Logan, UT 84321 , Phone: 4357531600

Shane R Larson
Anesthesiology Physician
NPI Number: 1528018496
Address: 274 N MAIN ST Logan, UT 84321 , Phone: 4357531600

Shane T Gonzales
Anesthesiology Physician
NPI Number: 1346290335
Address: 274 N MAIN ST Logan, UT 84321 , Phone: 4357531600

Brian D Nelson
Anesthesiology Physician
NPI Number: 1760432702
Address: 274 N MAIN ST Logan, UT 84321 , Phone: 4357531600

Frank E Peterson
Anesthesiology Physician
NPI Number: 1417907296
Address: 274 N MAIN ST Logan, UT 84321 , Phone: 4357531600

Jon R Robison
Anesthesiology Physician
NPI Number: 1013967801
Address: 274 N MAIN ST Logan, UT 84321 , Phone: 4357531600

Dr. Alan Hastings
Optometrist
NPI Number: 1679523245
Address: 1341 N MAIN ST Logan, UT 84341 , Phone: 4357530700

Shopko Stores Operating Co Llc
Durable Medical Equipment & Medical Supplies
NPI Number: 1750332730
Address: 1341 N MAIN ST Logan, UT 84341 , Phone: 4357532700

Steven G. Nail
Emergency Medicine Physician
NPI Number: 1114978137
Address: 1400 N 500 E Logan, UT 84341 , Phone: 4357162250

Shopko Stores Operating Co. Llc
Optometrist
NPI Number: 1609828136
Address: 1341 N MAIN ST Logan, UT 84341 , Phone: 4357530700

Mitchell R Udy
Audiologist
NPI Number: 1134174543
Address: 274 N MAIN ST Logan, UT 84321 , Phone: 4357531600

Alliance Home Health Of Northern Utah, Llc
Home Health Agency
NPI Number: 1003853672
Address: 965 S 100 W STE. 204 Logan, UT 84321 , Phone: 4357530707

Brant Wahlen Fonnesbeck
Family Medicine Physician
NPI Number: 1033156849
Address: 550 E 1400 N STE K Logan, UT 84341 , Phone: 4357556061

Rocky Mountain Emergency Specialists Llc
Emergency Medicine Physician
NPI Number: 1225078736
Address: 1400 N 500 E Logan, UT 84341 , Phone: 4357161000

Barry Gardner
Emergency Medical Services (Emergency Medicine) Physician
NPI Number: 1922049923
Address: 1400 N 500 E Logan, UT 84341 , Phone: 4357161000

Chris L Stegelmeier
Emergency Medical Services (Emergency Medicine) Physician
NPI Number: 1558302588
Address: 1400 N 500 E Logan, UT 84341 , Phone: 4357161000

Theral Michael Bishop
Emergency Medical Services (Emergency Medicine) Physician
NPI Number: 1376584300
Address: 1400 N 500 E Logan, UT 84341 , Phone: 4357161000

Shawn Joseph Aucoin
Pharmacist
NPI Number: 1538100227
Address: 1150 S 100 W Logan, UT 84321 , Phone: 4357874143

W Bryce Cook
Podiatrist
NPI Number: 1316989569
Address: 550 E 1400 N STE B Logan, UT 84341 , Phone: 4357529011

Mr. Keith Daines Hammond
General Practice Dentistry
NPI Number: 1366486524
Address: 290 N 200 E Logan, UT 84321 , Phone: 4357530505

Vikas Garg
Pain Medicine (Anesthesiology) Physician
NPI Number: 1104852599
Address: 274 N MAIN ST Logan, UT 84321 , Phone: 4357531600

Takiko M May
Internal Medicine Physician
NPI Number: 1952338121
Address: 1400 N 500 E Logan, UT 84341 , Phone: 4063632211

Dr. Casey N Isom
Specialist
NPI Number: 1215964275
Address: 550 EAST 1400 N SUITE S Logan, UT 84341 , Phone: 4357871108

Jon A Siler
Ophthalmology Physician
NPI Number: 1407885007
Address: 1300 N 500 E SUITE 350 Logan, UT 84341 , Phone: 4357527445

David G Waterman
Ophthalmology Physician
NPI Number: 1689603284
Address: 1300 N 500 E SUITE 350 Logan, UT 84341 , Phone: 4357527445

Praxair Healthcare Services, Inc.
Customized Equipment (DME)
NPI Number: 1700816436
Address: 165 E 1400 N SUITE D Logan, UT 84341 , Phone: 4357522100

Douglas P Plowman
Emergency Medical Services (Emergency Medicine) Physician
NPI Number: 1255362273
Address: 1400 N 500 E Logan, UT 84341 , Phone: 4357161000

Utah State University, Center For Persons With Disabilities
Developmentally Disabled Services Day Training Agency
NPI Number: 1356373807
Address: 6810 OLD MAIN HL Logan, UT 84322 , Phone: 4357977461

Gretchen Gimpel Peacock
Psychologist
NPI Number: 1104858695
Address: 2810 OLD MAIN HL DEPARTMENT OF PSYCHOLOGY Logan, UT 84322 , Phone: 4357970721

Dr. Melanie Marie Domenech Rodriguez
Psychologist
NPI Number: 1285666784
Address: 2810 OLD MAIN HL DPT. OF PSYCHOLOGY Logan, UT 84322 , Phone: 4357973059

Spence'S Prescription Pharmacy Inc
Community/Retail Pharmacy
NPI Number: 1902839715
Address: 550 E 1400 N Logan, UT 84341 , Phone: 4357538500

Spence'S Prescription Pharmacy
Community/Retail Pharmacy
NPI Number: 1891728606
Address: 981 S MAIN ST Logan, UT 84321 , Phone: 4357521111

Ryan J Stolworthy
Emergency Medical Services (Emergency Medicine) Physician
NPI Number: 1417981234
Address: 1400 N 500 E Logan, UT 84341 , Phone: 4357161000

Danny E Spencer
Emergency Medical Services (Emergency Medicine) Physician
NPI Number: 1508890682
Address: 1400 N 500 E Logan, UT 84341 , Phone: 4357161000

Edward Hunter Redd
Internal Medicine Physician
NPI Number: 1578597647
Address: 655 E 1300 N Logan, UT 84341 , Phone: 4357926491

John Barrett
Emergency Medical Services (Emergency Medicine) Physician
NPI Number: 1487688552
Address: 1400 N 500 E Logan, UT 84341 , Phone: 4357161000

Access Hospice Care Llc
Community Based Hospice Care Agency
NPI Number: 1376578708
Address: 74 W 100 N Logan, UT 84321 , Phone: 4357556599

Richard J Ingebretsen
Emergency Medical Services (Emergency Medicine) Physician
NPI Number: 1447285762
Address: 1400 N 500 E Logan, UT 84341 , Phone: 4357161000

Access Home Care Llc
Home Health Agency
NPI Number: 1427083898
Address: 74 W 100 N Logan, UT 84321 , Phone: 4357556599

Lee S Broadbent
Surgery Physician
NPI Number: 1265467567
Address: 550 E 1400 N SUITE D Logan, UT 84341 , Phone: 4357527122

Mrs. Elizabeth Lund
Clinical Social Worker
NPI Number: 1477578672
Address: 175 W 1400 N STE A LDS FAMILY SERVICES Logan, UT 84341 , Phone: 4357525302