UNIVERSITY OF UTAH PEDIATRIC SERVICES


Address: 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125
Phone: 8015876336

UNIVERSITY OF UTAH PEDIATRIC SERVICES (NPI# 1104370691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104370691
Entity Type Organization
Organization Name UNIVERSITY OF UTAH PEDIATRIC SERVICES
Other Organization Name PEDIATRIC TRANSPLANT
Practice Address 81 N Mario Capecchi Dr
Salt Lake City
UT 84113-1125
Mailing Address Po Box 841450
Los Angeles
CA 90084-1450
Practice Telephone 8015876336
Mailing Telephone 8012133900
Enumeration Date 2016-08-12
Last Update Date 2020-05-21
Authorized Official Name EDWARD CLARK (DEPARTMENT CHAIR)
Authorized Official Telephone 8015876336
Authorized Official Credential MD
Is Organization Subpart Y
Parent Organization Name UNIVERSITY OF UTAH PEDIATRIC SERVICES

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 204F00000X Transplant Surgery Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Pediatric Transplant Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1669918769 University of Utah Pediatric Services Pediatrics 1645 Pancheri Dr, Idaho Falls, ID 83402-3169 2017-01-12
1386257152 University of Utah Pediatric Services Orthopaedic Surgery 9385 S Snowbird Center Dr, Sandy, UT 84092-6249 2020-08-31
1023542388 University of Utah Pediatric Services Pediatrics 2360 Mullan Rd, Sutie C, Missoula, MT 59808-1811 2017-04-13
1760928865 University of Utah Pediatric Services Internal Medicine 110 Vista Dr, Pocatello, ID 83201-5824 2017-01-12
1235675364 University of Utah Pediatric Services Urology 1645 Pancheri Dr, Idaho Falls, ID 83402-3169 2017-01-12
1922552413 University of Utah Pediatric Services Surgery 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2016-08-12
1578017067 University of Utah Pediatric Services Pediatrics 100 N Mario Capecchi Dr, 1, Salt Lake City, UT 84113-1103 2016-08-12
1568916054 University of Utah Pediatric Services Pediatrics 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2016-08-12
1245682509 University of Utah Pediatric Services Pediatrics 98 Poplar St, Blackfoot, ID 83221-1758 2016-07-11
1346692605 University of Utah Pediatric Services Pediatrics 450 E Main St, Rexburg, ID 83440-2048 2016-07-11

Office Location

Street Address 81 N MARIO CAPECCHI DR
City SALT LAKE CITY
State UT
Zip Code 84113-1125

Providers in the same location

NPI Name Taxonomy Address Enumeration
1922012251 Jeffrey Marvin Dalley Social Worker 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2006-07-29
1255946588 Sarah Elizabeth Roberts Dietitian, Registered 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-09-14
1144835885 Rachel Coffey Social Worker 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-09-10
1457965865 Mallory Caitlin Kidwell Clinic/Center 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-09-02
1063021699 Sara Stevenson Dietitian, Registered 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-07-29
1780292318 Katherine Ruesch Nurse Practitioner 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-07-20
1124646062 Nathaniel Edward Hayward Student in an Organized Health Care Education/Training Program 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-07-07
1780209544 Paul Clark Bluth Student in an Organized Health Care Education/Training Program 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-06-08
1477177939 Kristen Wong Genetic Counselor, MS 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-06-01
1891316170 Brianna Dougall Registered Nurse 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-04-28
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1386111060 Melissa Marie Dixon Psychologist Primary Children's Hospital Outpatient Services, 81 South Mario Capecchi Drive, Salt Lake City, UT 84113 2018-10-31
1366965618 Ashley Stuart Psychologist 44 North Mario Capecchi Drive, Salt Lake City, UT 84113 2017-07-19
1487945135 Justin C Wheeler Pediatrics 81 N Mario Capecchi Dr Fl 4, Salt Lake City, UT 84113 2011-04-29
1154612117 Dana Boucek Pediatrics 100 North Mario Capecchi Dr., Primary Children's, Salt Lake City, UT 84113 2011-04-26
1285959502 Anna Katherine Eyre Ermarth Pediatrics 81 Mario Capecchi, Salt Lake City, UT 84113 2010-03-30
1457682072 Elizabeth K Cho Nurse Practitioner 100 North Mario Cappechi Dr., Salt Lake City, UT 84113 2010-01-21
1528290848 Nancy Crandell Brown Nurse Practitioner 100 North Mario Cappechi Drive, Salt Lake City, UT 84113 2009-08-20
1679708481 Primary Children's Medical Center General Acute Care Hospital 100 No. Mario Capecchi Drive, Salt Lake, UT 84113 2009-05-22
1467697235 Tara Hook Physical Therapist 100 North Mario Capecchi Dr, Salt Lake City, UT 84113 2008-12-09
1144474768 Jennifer K Workman Pediatrics 100 N Mario Capecchi Drive, Pediatric Crtical Care, Primary Children's Hospital, Salt Lake City, UT 84113 2008-11-10
Find all providers in zip 84113

Taxonomy Information

Taxonomy Code 204F00000X
Grouping Allopathic & Osteopathic Physicians
Classification Transplant Surgery

Taxonomy Definition

Definition to come.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1154515765 Timothy J Gayowski Transplant Surgery 144 S 500 E, Salt Lake City, UT 84102-1907 2007-08-28
1427104017 Paul Jeffrey Campsen Transplant Surgery 30 N 1900 E, Salt Lake City, UT 84132-0002 2007-01-26
1679519771 Robin Davis Kim Transplant Surgery 30 N 1900 E, Salt Lake City, UT 84132-0002 2006-06-20

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1093236895 Chantel Leigh Duffey Transplant Surgery 5169 S Cottonwood St Ste 320, Murray, UT 84107-6768 2017-06-30
1275740607 Diane Alonso Transplant Surgery 5171 Cottonwood St, Suite 650, Murray, UT 84107-5704 2007-05-16
1760542054 Ivan Rodrigo Zendejas Ruiz Transplant Surgery 5171 S Cottonwood St, Ste 650, Murray, UT 84107-5716 2006-12-09
1205871043 Shiro Fujita Transplant Surgery 5171 Cottonwood St, Suite 650, Murray, UT 84107-5704 2006-06-17

Competitor

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City SALT LAKE CITY
Zip Code 84113

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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