DR. BRIAN LILJENQUIST PLLC (NPI# 1174062376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174062376 |
| Entity Type | Organization |
| Organization Name | DR. BRIAN LILJENQUIST PLLC |
| Other Organization Name | SURGICAL WOUND CARE ASSOCIATES |
| Practice Address |
1250 E 3900 S Ste 440 Salt Lake City UT 84124 |
| Mailing Address |
1250 E 3900 S Ste 440 Salt Lake City UT 84124-1349 |
| Practice Telephone | 8018694100 |
| Practice Fax Number | 8018694119 |
| Mailing Telephone | 8018694100 |
| Mailing Fax Number | 8018694119 |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | DR. BRIAN LILJENQUIST (MANAGING PARTNER) |
| Authorized Official Telephone | 8018694100 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 9140789-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 8763069-1204 | UT | Allopathic & Osteopathic Physicians |
| N | 2086S0127X |
Surgery Specialization: Trauma Surgery |
8763069-1204 | UT | Allopathic & Osteopathic Physicians |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
83699990501 | UT | Podiatric Medicine & Surgery Service Providers |
| N | 2251G0304X |
Physical Therapist Specialization: Geriatrics |
292357-2401 | UT | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
8763069-12 | UT | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Elite Primary Care | Doing Business As Name - Organization |
| Surgical Wound Care Associates | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1250 E 3900 S Ste 440, Salt Lake City, UT 841241349 | 8019990261 | 8444366836 |
| 325 W Center St, Spanish Fork, UT 846602060 | 8019990261 | 8444366836 |
| Street Address |
1250 E 3900 S STE 440 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841586096 | Brian B Liljenquist | Podiatrist | 1250 E 3900 S Ste 440, Salt Lake City, UT 84124 | 2011-06-27 |
| 1487260550 | Doctors House Calls of Utah, LLC | Clinic/Center | 1250 E 3900 S Ste 440, Salt Lake City, UT 84124-1349 | 2020-09-23 |
| 1326541145 | Robert Chynoweth | Physical Therapist | 1250 E 3900 S Ste 440, Salt Lake City, UT 84124-1349 | 2018-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487273298 | Shannon Penny Price | Social Worker | 4465 Maybeck Place, Condo C, Millcreek, UT 84124 | 2020-04-11 |
| 1922654367 | Joseph C Melvin Md PC | Colon & Rectal Surgery | 1250 East 3900 South Ste 320, Salt Lake City, UT 84124 | 2019-08-12 |
| 1366923252 | Melanie Stumpf | Counselor | 1141 E 3900, Suite A170, Salt Lake City, UT 84124 | 2018-08-28 |
| 1376033993 | Michelle Flowers | Speech-Language Pathologist | 2120 East 3900 South, Ste 200, Holladay, UT 84124 | 2018-05-18 |
| 1740797257 | Lissa Anne Hutchings | Nurse Practitioner | 1160 E 3900 S Ste 4100, Salt Lake City, UT 84124 | 2018-01-05 |
| 1316465693 | Randy Gines | Counselor | 4460 S Highland Drive # 230, Murray, UT 84124 | 2017-09-06 |
| 1417470717 | Joshua Chandler Spencer | Counselor | 4460 South Highland Dr., 230, Murray, UT 84124 | 2017-07-19 |
| 1659891554 | Marcus Whitney | Counselor | 4460 S Highland Dr. # 230, Murray, UT 84124 | 2017-06-21 |
| 1518496884 | Courtney Nilson | Counselor | 4460 S. Highland Dr. #230, Murray, UT 84124 | 2017-06-08 |
| 1841687126 | Intrafilrx | Preferred Provider Organization | 3920 S 1100 E Ste 210, Salt Lake City, UT 84124 | 2015-04-23 |
| Find all providers in zip 84124 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649882069 | Vasco Healthcare Inc | Clinic/Center | 470 E 3900 S Ste 100, Salt Lake City, UT 84107-2331 | 2020-08-18 |
| 1487184610 | Heron Medical Pllc | Clinic/Center | 77 S 700 E Ste 220, Salt Lake City, UT 84102-1162 | 2017-06-20 |
| 1669683579 | University Health Care | Clinic/Center | 30 N 1900 E # 3r210, Salt Lake City, UT 84132-2305 | 2007-05-24 |
| 1114145224 | Bilingual Health Care Center | Clinic/Center | 650 S Redwood Rd, Salt Lake City, UT 84104-3617 | 2007-04-23 |
| 1831214253 | Ihc Health Services Inc | Clinic/Center | 675 E 500 S, Ste 300, Salt Lake City, UT 84102-2818 | 2007-03-21 |
| 1699795831 | Ihc Health Services, Inc. | Clinic/Center | 325 8th Ave, Salt Lake City, UT 84143-0001 | 2006-07-20 |
| 1689153561 | Community Birth Group | Clinic/Center | 1172 E 4th Ave, Salt Lake City, UT 84103-4124 | 2018-08-10 |
| 1174033989 | University of Utah Adult Services | Clinic/Center | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2017-10-06 |
| 1851826192 | Finding Home Healthcare, Inc. | Clinic/Center | 1385 W 2200 S Ste 201, Salt Lake City, UT 84119-7208 | 2017-04-24 |
| 1790192235 | Healthworks Med Group of Utah P C | Clinic/Center | 222 S Main St, Salt Lake City, UT 84101-2174 | 2014-07-16 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84124 |
Please comment or provide details below to improve the information on DR. BRIAN LILJENQUIST PLLC.
| 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.