DR. JEREMY ROBERT CHIDESTER (NPI# 1194015693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194015693 |
| Entity Type | Individual |
| Full Name | DR. JEREMY ROBERT CHIDESTER |
| Credential | M.D. |
| Practice Address |
11762 S State St Ste 333 Draper UT 84020-7166 |
| Practice Telephone | 8018395557 |
| Mailing Telephone | 8018395557 |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2020-04-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | 10668647-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 2082S0105X |
Plastic Surgery Specialization: Surgery of the Hand |
10668647-1205 | UT | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6322 S 3000 E Ste 170, Salt Lake City, UT 841217290 | 8015133223 |
| Street Address |
11762 S STATE ST STE 333 |
| City | DRAPER |
| State | UT |
| Zip Code | 84020-7166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558983775 | Jerry Chidester Md Pllc | Clinic/Center | 11762 S State St Ste 333, Draper, UT 84020-7166 | 2020-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194322776 | Chase Larsen Dmd Pllc | Dentist | 723 E 12200 S, Draper, UT 84020 | 2020-10-06 |
| 1780222380 | Derek Cragun | Counselor | 11706 700 E, Draper, UT 84020 | 2019-12-13 |
| 1720629371 | Own My Health Medical | Clinic/Center | 12371 900 E, Suite 102, Draper, UT 84020 | 2019-10-04 |
| 1508418856 | Thomas Mifflin | Physician Assistant | 721 East 12200 South, Draper, UT 84020 | 2019-07-16 |
| 1124670872 | Necia Dalley | Registered Nurse | 11800 S State St, Draper, UT 84020 | 2019-07-12 |
| 1285100784 | Tracey M Williams | Psychologist | 13200 S 1601 E, Draper, UT 84020 | 2018-10-23 |
| 1275008328 | Amoni Paeahelotu Finau | Community Health Worker | 13703 Wheatfield Way, Draper, UT 84020 | 2018-10-04 |
| 1891275525 | Cynthia Mae Bolton | Psychologist | 1192 E Draper Parkway # 447, Draper, UT 84020 | 2018-08-21 |
| 1164908026 | Headin' Home Inc. | Community/Behavioral Health | 12300 S. 150 W., Draper, UT 84020 | 2018-07-13 |
| 1366932576 | Forest Hulet | Dentist | 219 E 12300, Ste I-5, Draper, UT 84020 | 2018-05-14 |
| Find all providers in zip 84020 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760572366 | Richard H Fryer | Plastic Surgery | 11762 S State St Ste 220, Draper, UT 84020-7156 | 2006-10-13 |
| 1427038256 | Jed Reed Bindrup | Plastic Surgery | 11762 So State St, Suite 260, Draper, UT 84020-7156 | 2006-01-18 |
| 1659666295 | Nicholas Kay Howland | Plastic Surgery | 11762 S State St Ste 220, Draper, UT 84020-7156 | 2011-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518591874 | Slc Plastic Surgery LLC | Plastic Surgery | 6686 Highland Drive, Cottonwood Heights, UT 84121 | 2020-02-26 |
| 1073151536 | Christine A. Cheng Md PC | Plastic Surgery | 415 Medical Dr Ste D102, Bountiful, UT 84010-8906 | 2019-12-16 |
| 1477016079 | Teresa Zavala | Plastic Surgery | 6169 W Ridge Mesa Cir, West Valley City, UT 84128-5638 | 2019-04-10 |
| 1477041101 | Cranio Ninja LLC | Plastic Surgery | 1055 N 300 W Ste 301, Provo, UT 84604-3373 | 2018-04-27 |
| 1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
| 1841736501 | Refine The Body Inc | Plastic Surgery | 1300 N 500 E Ste 260, Logan, UT 84341-2417 | 2017-01-18 |
| 1720320179 | Melody Scheefer Van Boerum | Plastic Surgery | 5445 S Highland Dr, Salt Lake City, UT 84117-7629 | 2013-03-25 |
| 1508156928 | Richard Tyrell | Plastic Surgery | 30 N 1900 E Rm 3b400, Salt Lake City, UT 84132-0002 | 2011-04-19 |
| 1851617815 | Dana Nicole Johns | Plastic Surgery | University of Utah Hospital 50 N Medical Dr, Salt Lake City, UT 84132-0002 | 2010-04-15 |
| 1760705594 | Craig Davis | Plastic Surgery | 3163 N Grasslands Pkwy, Washington, UT 84780-2097 | 2010-03-08 |
| Find all providers with the same taxonomy | ||||
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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.