MR. JERRY WILLIAM HUSSONG (NPI# 1346201209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346201209 |
| Entity Type | Individual |
| Full Name | MR. JERRY WILLIAM HUSSONG |
| Credential | DDS MD |
| Practice Address |
500 S Chipeta Way Salt Lake City UT 84108-1221 |
| Practice Telephone | 8015832787 |
| Practice Fax Number | 8015845141 |
| Mailing Telephone | 8015832787 |
| Mailing Fax Number | 8015845141 |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2013-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZH0000X |
Pathology Specialization: Hematology |
3403921205 | UT | Allopathic & Osteopathic Physicians |
| N | 207ZH0000X |
Pathology Specialization: Hematology |
G86484 | CA | Allopathic & Osteopathic Physicians |
| N | 207ZH0000X |
Pathology Specialization: Hematology |
9291 | NV | Allopathic & Osteopathic Physicians |
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
3403921205 | UT | Allopathic & Osteopathic Physicians |
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
G86484 | CA | Allopathic & Osteopathic Physicians |
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
9291 | NV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 200225018 | 05 |
| Street Address |
500 S CHIPETA WAY |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84108-1221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750909289 | Bryce A. Macek | Pathology | 500 S Chipeta Way, Salt Lake City, UT 84108-1221 | 2020-07-10 |
| 1235766627 | Phillip Marshall Bennett | Student in an Organized Health Care Education/Training Program | 500 S Chipeta Way, Salt Lake City, UT 84108-1221 | 2020-03-25 |
| 1093135519 | Lincoln Joseph Pac | Pathology | 500 S Chipeta Way, Salt Lake City, UT 84108-1221 | 2014-04-23 |
| 1396163093 | Rebecca Millar Harris | Pathology | 500 S Chipeta Way, Arup Laboratories, Salt Lake City, UT 84108-1221 | 2014-04-01 |
| 1912337544 | Sara Velden | Genetic Counselor, MS | 500 S Chipeta Way, Mail Code 398-d01, Salt Lake City, UT 84108-1221 | 2013-11-18 |
| 1366572919 | Marcia Theresa Jodah | Genetic Counselor, MS | 500 S Chipeta Way, Salt Lake City, UT 84108-1221 | 2007-03-06 |
| 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 | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962842864 | Matthew Scott Johnson | Pathology | 2000 Circle of Hope Dr Rm N3100, Salt Lake City, UT 84112-5550 | 2013-06-25 |
| 1578852661 | Jolanta Jedrzkiewicz | Pathology | 434 2nd Ave Apt 4, Salt Lake City, UT 84103-5623 | 2011-03-30 |
| 1891922951 | Thomas Cary Wilson | Pathology | 5330 S 900 E Ste 120, Salt Lake City, UT 84117-3504 | 2009-06-16 |
| 1780822809 | Dana Claire Gingell | Pathology | 1372 S 300 E, Salt Lake City, UT 84115-1502 | 2009-01-27 |
| 1639315070 | Benjamin Lloyd Witt | Pathology | University of Utah 50 N Medical Dr, Department of Pathology, Salt Lake City, UT 84132-0001 | 2009-01-06 |
| 1164683959 | Jessica Comstock | Pathology | 100 N Mario Cappechi Dr, Primary Childrens Medical Center Dept of Pathology, Salt Lake City, UT 84113 | 2008-06-24 |
| 1932308152 | Daniel Joseph Albertson | Pathology | 1950 Circle of Hope Dr Rm N3105, Huntsman Cancer Hospitadepartment of Surgical Pathology, Salt Lake City, UT 84112-5500 | 2007-07-17 |
| 1639299324 | Edward Hubert Hart | Pathology | University of Utah Hospital Pathology, 50 N Medical Dr, Salt Lake City, UT 84132-0100 | 2007-03-29 |
| 1760547855 | Joseph P. Gormley | Pathology | 15 N Medical Dr Ste 1100, Salt Lake City, UT 84112-1100 | 2006-12-27 |
| 1912940164 | Elizabeth M Jensen | Pathology | 1200 East 3900 South, Salt Lake City, UT 84124-1300 | 2006-06-14 |
| 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.