Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blue Rock Neurological LLC

Organization Addiction Medicine (Family Medicine) Physician · NPI 1730554734

Blue Rock Neurological LLC is an Addiction Medicine (Family Medicine) Physician in Provo, Utah. Licensed in Utah. Registered with an NPI since 2015.

Licensed in
UT
In the registry since
2015
Specialties on file
5
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3152 N University Ave Ste 220
Provo, UT 84604-4746
Phone: (801) 229-1014
Fax: (801) 229-1067
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X (UT)
Addiction Medicine (Family Medicine) Physician Taxonomy 207QA0401X (UT)
Interventional Pain Medicine Physician Taxonomy 208VP0014X (UT)
Medical Physician Assistant Taxonomy 363AM0700X (UT)
Family Nurse Practitioner Taxonomy 363LF0000X (UT)

Record details

NPI number1730554734
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Wendell Gibby — Manager/Owner · (801) 229-1014
NPI enumeratedDecember 2, 2015
Last updated in NPPESDecember 2, 2015
Mailing address3152 N University Ave Ste 220, Provo, UT 84604-4746

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