DR. TOBY MERRILL ENNISS (NPI# 1295915536) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295915536 |
| Entity Type | Individual |
| Full Name | DR. TOBY MERRILL ENNISS |
| Credential | M.D. |
| Practice Address |
30 N. 1900 East, Mreb 307 University of Utah School of Medicine, Dept. of Surgery Salt Lake City UT 84132 |
| Mailing Address |
30 N. 1900 East, Mreb 307 University of Utah School of Medicine, Dept. of Surgery Salt Lake City UT 84132-0001 |
| Practice Telephone | 8015857280 |
| Practice Fax Number | 8015879370 |
| Mailing Telephone | 8015857280 |
| Mailing Fax Number | 8015879370 |
| Enumeration Date | 2007-11-03 |
| Last Update Date | 2018-07-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 7643802-1205 | UT | Allopathic & Osteopathic Physicians |
| Y | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
7643802-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 2086S0127X |
Surgery Specialization: Trauma Surgery |
7643802-1205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | STATE CONTROLLED SUBSTANCE NUMBER | 7643802-8905 | 01 |
| UT | STATE MEDICAL LICENSE | 7643802-1205 | 01 |
| FEDERAL DEA # | FE1070731 | 01 |
| Street Address |
30 N. 1900 EAST, MREB 307 UNIVERSITY OF UTAH SCHOOL OF MEDICINE, DEPT. OF SURGERY |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275162331 | Scott Andrew Rizzi | Student in an Organized Health Care Education/Training Program | 30 North 1900 East Som 4c116, Salt Lake City, UT 84132 | 2020-04-02 |
| 1609421403 | Monika Fleckenstein | Ophthalmology | 65 Mario Capecchi Drive, John A. Moran Eye Center, Salt Lake City, UT 84132 | 2019-08-08 |
| 1366975914 | Jacob Brandenburg | Anesthesiology | School of Medicine 30 North 1900 East Room 3c444, Salt Lake City, UT 84132 | 2017-04-10 |
| 1568815082 | Anastasia Neufeld | Ophthalmology | 65 Mario Capecchi Drive, Salt Lake City, UT 84132 | 2016-07-20 |
| 1912350083 | Gmaan Alzhrani | Student in an Organized Health Care Education/Training Program | 175 N. Medical Drive East , Salt Lake City, UT 84132 | 2016-07-13 |
| 1831544600 | Drew Goerke | Occupational Therapist | 50 N Medical Drive, Som Room #1r73, Salt Lake City, UT 84132 | 2016-04-29 |
| 1891179024 | Bong Jik Kim | Student in an Organized Health Care Education/Training Program | 50 North Medical Drive 3c120, Otolaryngology Administration Office, Salt Lake City, UT 84132 | 2015-07-17 |
| 1043699101 | Chris Anderson | Physician Assistant | 30 North 1900 East #3c344, Salt Lake City, UT 84132 | 2015-05-22 |
| 1689061822 | Ryan Clark | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 30 N 1900 E Som 3c127, Salt Lake City, UT 84132 | 2015-04-24 |
| 1649666264 | Kevin Conrad | Anesthesiology | 30 N 1900 E Room 3c444, Salt Lake City, UT 84132 | 2015-04-09 |
| Find all providers in zip 84132 | ||||
| Taxonomy Code | 2086S0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Critical Care |
| A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942604632 | University of Utah Acuity Care Services | Surgery | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2014-10-09 |
| 1063754265 | Marta Louise Mccrum | Surgery | 30 N 1900 E, Division of General Surgery, Salt Lake City, UT 84132-0002 | 2013-03-26 |
| 1659461275 | Jeffrey R. Saffle | Surgery | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2006-10-13 |
| 1831108166 | University of Utah Surgical Associates | Surgery | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649319500 | Eric D Anderson | Surgery | 5169 Cottonwood St Ste 410, Murray, UT 84107-6769 | 2007-02-06 |
| City | SALT LAKE CITY |
| Zip Code | 84132 |
Please comment or provide details below to improve the information on DR. TOBY MERRILL ENNISS.
| 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.