MR. ERIC WALLACE GLISSMEYER (NPI# 1245490424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245490424 |
| Entity Type | Individual |
| Full Name | MR. ERIC WALLACE GLISSMEYER |
| Credential | MD |
| Practice Address |
295 Chipeta Way Salt Lake City UT 84108-1287 |
| Mailing Address |
1966 S 700 E Bountiful UT 84010-4104 |
| Practice Telephone | 8015877450 |
| Mailing Telephone | 8012980076 |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2011-12-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 282NC2000X |
General Acute Care Hospital Specialization: Children |
UT | Hospitals | |
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
295 CHIPETA WAY |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84108-1287 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891751384 | Emily A Thorell | Pediatrics | 295 Chipeta Way, 2s010, Salt Lake City, UT 84108-1287 | 2006-04-24 |
| 1760851075 | Jacob Kean | Speech-Language Pathologist | 295 Chipeta Way, Williams Building, Rm 1n490, Salt Lake City, UT 84108 | 2015-09-16 |
| 1215293667 | Reena Patel Tam | Pediatrics | 295 Chipeta Way, Salt Lake City, UT 84108-1287 | 2012-04-10 |
| 1437447190 | Tiffany Kae Profsky | Nurse Practitioner | 295 Chipeta Way, Salt Lake City, UT 84108-1287 | 2011-07-15 |
| 1902110232 | Larissa Beyerlein | Pediatrics | 295 Chipeta Way, Department of Pediatric Emergency Medicine, Salt Lake City, UT 84158 | 2010-07-28 |
| 1629303839 | Caroline Hagedorn | Nurse Practitioner | 295 Chipeta Way, Salt Lake City, UT 84108-1287 | 2009-10-05 |
| 1295995694 | France A Davis II | Physician Assistant | 295 Chipeta Way, Salt Lake City, UT 84108-1287 | 2008-06-10 |
| 1669631826 | Tamara Elena Pool | Pediatrics | 295 Chipeta Way, Salt Lake City, UT 84108-1287 | 2008-06-03 |
| 1811164031 | Shrena Patel | Pediatrics | 295 Chipeta Way, Salt Lake City, UT 84108-1287 | 2008-05-15 |
| 1225202260 | Allison Anne Keller | Emergency Medicine | 295 Chipeta Way, Salt Lake City, UT 84108-1220 | 2008-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548753056 | Maxine Ht Erickson | Assistant Behavior Analyst | 780 Guardsman Way, Salt Lake City, Ut 84108, Salt Lake City, USA 84108 | 2018-06-08 |
| 1841704061 | Robyn Carver | Occupational Therapist | 421 Wakara Wat, Salt Lake City, UT 84108 | 2017-11-27 |
| 1518478742 | Lcr Dental Sugar House | Dentist | 2068 S 2100 E Suite #a, Salt Lake City, UT 84108 | 2017-10-16 |
| 1447708912 | Aubrianne Squire Evans | Occupational Therapist | 421 S Wakara Way Ste 201, Salt Lake City, UT 84108 | 2016-09-14 |
| 1629524426 | Ryan Weisenbeck | Specialist/Technologist | 580 S Guardsman Way, Salt Lake City, UT 84108 | 2016-08-31 |
| 1164885547 | Michael Fazzone | Student in an Organized Health Care Education/Training Program | 530 South Wakara Way, University of Urah, School of Dentistry, Salt Lake City, UT 84108 | 2016-04-01 |
| 1669833489 | Bryon Claflin | Registered Nurse | 650 S Komas Ste 200, Salt Lake City, UT 84108 | 2016-03-08 |
| 1801283833 | Autism Assement Treatment Program Adult | Psychologist | 650 S Komas, Suite 200, Salt Lake City, UT 84108 | 2015-04-16 |
| 1578993275 | Matthew and David Dental Pllc | Dentist | 1355 Foothill Drive, Salt Lake City, UT 84108 | 2013-11-15 |
| 1841631520 | Deepika Garg | Internal Medicine | 675 S Arapeen Dr Ste 205, Salt Lake City, UT 84108 | 2013-07-10 |
| Find all providers in zip 84108 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205829 | Brittany Nicole Beverly | Student in an Organized Health Care Education/Training Program | 236 N Sun Arbor Ter Apt 2111, Salt Lake City, UT 84116-4537 | 2020-11-06 |
| 1508484023 | Courtney Hook | Student in an Organized Health Care Education/Training Program | 1860 E 250 S Hper East, Room 208, Salt Lake City, UT 84112 | 2020-07-10 |
| 1669090502 | Kelly Maree Gutpell | Student in an Organized Health Care Education/Training Program | 81 N Mario Capecchi Dr Ste 1a.011, Salt Lake City, UT 84113-1125 | 2020-07-07 |
| 1134744014 | Scarlet Reyes | Student in an Organized Health Care Education/Training Program | 25 S 1100 E Apt 14, Salt Lake City, UT 84102-1514 | 2020-06-16 |
| 1215553151 | Andrew Winn Bringhurst | Student in an Organized Health Care Education/Training Program | 1737 E Imperial Park Sq, Salt Lake City, UT 84106-5104 | 2020-06-16 |
| 1134744287 | Jillian G Barker | Student in an Organized Health Care Education/Training Program | 1345 S 400 E, Salt Lake City, UT 84115-1548 | 2020-06-15 |
| 1114542255 | Gustavo Carrillo | Student in an Organized Health Care Education/Training Program | 1652 W 800 S, Salt Lake City, UT 84104-3112 | 2020-06-15 |
| 1982229035 | Cristhian V. Toruno | Student in an Organized Health Care Education/Training Program | 448 N 1100 W, Salt Lake City, UT 84116-2649 | 2020-06-15 |
| 1144845108 | Huong T Pham | Student in an Organized Health Care Education/Training Program | 319 E Beldon Pl, Salt Lake City, UT 84111-3516 | 2020-06-15 |
| 1790300754 | Krista Huffaker | Student in an Organized Health Care Education/Training Program | 1212 E 500 S # 2, Salt Lake City, UT 84102-3223 | 2020-06-15 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84108 |
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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.