DR. ELISABETH A FERLIC (NPI# 1114185634) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114185634 |
| Entity Type | Individual |
| Full Name | DR. ELISABETH A FERLIC |
| Credential | M.D. |
| Practice Address |
9720 S 1300 E Suite E230 Sandy UT 84094-3712 |
| Practice Telephone | 8015012950 |
| Practice Fax Number | 8015012951 |
| Mailing Telephone | 8015012950 |
| Mailing Fax Number | 8015012951 |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2016-01-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 9017811-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 56312 | MN | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 42235 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 470009 | 05 |
| Street Address |
9720 S 1300 E SUITE E230 |
| City | SANDY |
| State | UT |
| Zip Code | 84094-3712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821075912 | Larry D Fullmer | Physical Therapist | 9720 S 1300 E, #w200, Sandy, UT 84094-3712 | 2005-12-29 |
| 1700329091 | David R Boettger Md PC | Pediatrics | 9720 S 1300 E, Sandy, UT 84094-3712 | 2016-11-18 |
| 1124470133 | Katherine Heller | Nurse Practitioner | 9720 S 1300 E, Suite W-120, Sandy, UT 84094-3712 | 2016-07-01 |
| 1316357197 | Ihc Health Services Inc | Urology | 9720 S 1300 E, Ste E230, Sandy, UT 84094-3771 | 2014-05-02 |
| 1396186847 | Alex Mecham | Physical Therapist | 9720 S 1300 E, #w200, Sandy, UT 84094-3712 | 2013-07-12 |
| 1225479777 | Stephanie Shew | Physical Therapist | 9720 S 1300 E, #w200, Sandy, UT 84094-3712 | 2013-07-12 |
| 1508145111 | Ihc Health Services Inc | Family Medicine | 9720 S 1300 E, Ste E240, Sandy, UT 84094-3795 | 2011-08-12 |
| 1649560269 | Amy E Rapp | Pediatrics | 9720 S 1300 E, Suite 100, Sandy, UT 84094-3712 | 2011-04-15 |
| 1891997557 | Woodrow Cannon Marriott | Pediatrics | 9720 S 1300 E, Suite E 100, Sandy, UT 84094-3712 | 2007-06-04 |
| 1790816973 | Ihc Health Services Inc | Pediatrics | 9720 S 1300 E, #100, Sandy, UT 84094-3712 | 2007-03-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649754508 | Hollie J Wharton | Advanced Practice Midwife | 9450 S. 1300 E., Sandy, UT 84094 | 2018-09-18 |
| 1417306804 | Sarah Scheibe | Counselor | 1123 E Tulane Cir, Sandy, UT 84094 | 2016-06-07 |
| 1457771313 | Zhenhao Liu | Internal Medicine | 11333 S 1000 E Ste 100, Sandy, UT 84094 | 2014-04-18 |
| 1770919714 | Bojan Jurosevic | Physical Therapist | 7940 South 1300 East, Sandy, UT 84094 | 2013-09-23 |
| 1104259464 | Ryan Blick | Marriage & Family Therapist | 833 East 9400 South, Sandy, UT 84094 | 2013-08-09 |
| 1780027821 | Lauren Coyle | Obstetrics & Gynecology | 9600 S 1300 E Ste 308, Sandy, UT 84094 | 2013-04-08 |
| 1285971697 | Robert W Later Md PC | Specialist | 9600 S 1300 E Suite 302, Sandy, UT 84094 | 2013-01-07 |
| 1306149679 | Premier Home Health, LLC | Home Health | 978 Larkspur Dr, Sandy, UT 84094 | 2010-12-08 |
| 1760704753 | Altaview Hospital | General Acute Care Hospital | 9660 South 13th East, Sandy, UT 84094 | 2010-02-18 |
| 1750518676 | Julie Christensen | Social Worker | 833 E 9400 S, Sandy, UT 84094 | 2009-06-18 |
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| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316357197 | Ihc Health Services Inc | Urology | 9720 S 1300 E, Ste E230, Sandy, UT 84094-3771 | 2014-05-02 |
| 1063539401 | Richard F. Labasky, Md, PC | Urology | 9600 S 1300 E, Suite #301, Sandy, UT 84094-3766 | 2007-03-22 |
| 1538226600 | Richard Francis Labasky | Urology | 9600 S 1300 E, #303, Sandy, UT 84094-3766 | 2007-01-02 |
| 1770591620 | Stanley Corbin Clark | Urology | 9690 S 1300 E, 100, Sandy, UT 84094-3721 | 2006-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945061 | Utah Urology Works LLC | Urology | 4252 S Highland Dr Ste 200, Salt Lake City, UT 84124-2690 | 2020-06-05 |
| 1619402286 | Andrew Mazzone | Urology | University of Utah Som Division of Urology, 30 North 1900 East, Salt Lake City, UT 84132-0001 | 2017-04-20 |
| 1588195135 | Laurel S. Mast | Urology | 30 N 1900 E Rm 3b427, Salt Lake City, UT 84132-0002 | 2017-03-24 |
| 1164845517 | Bruce Wayne Carlin | Urology | 375 Old Farm Ln, Coalville, UT 84017-6706 | 2014-01-21 |
| 1104182476 | Jeffrey David Sparenborg | Urology | 1157 N 300 W Ste 301, Provo, UT 84604-6124 | 2012-04-11 |
| 1588933527 | Hal H Bourne | Urology | 3250 Millcreek Dell Ln, Salt Lake City, UT 84109-3184 | 2011-12-20 |
| 1740598887 | Ihc Health Services Inc | Urology | 4403 Harrison Blvd Ste 4440, Ogden, UT 84403-3291 | 2010-09-23 |
| 1083922926 | Perry T. Walters, M.d. PC | Urology | 425 Medical Drive #112, Bountiful, UT 84010 | 2010-09-14 |
| 1447589288 | Joseph Robert Armstrong | Urology | 3291 Piute Dr, Provo, UT 84604-4849 | 2009-12-07 |
| 1851627756 | Ned Legrande Mangelson | Urology | 2691 Roxbury Cir, Salt Lake City, UT 84108-2841 | 2009-10-27 |
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| 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.