NATHAN G MOMBERGER MD PC (NPI# 1366624991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366624991 |
| Entity Type | Organization |
| Organization Name | NATHAN G MOMBERGER MD PC |
| Practice Address |
5848 Fashion Blvd Ste 110 Salt Lake City UT 84107-6121 |
| Practice Telephone | 8013145026 |
| Practice Fax Number | 8013144015 |
| Mailing Telephone | 8013145026 |
| Mailing Fax Number | 8013144015 |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2010-11-10 |
| Authorized Official Name | GENE R OAKES (BUSINESS ADMINISTRATOR) |
| Authorized Official Telephone | 8013145026 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
3208681205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 528299949009 | 05 |
| Street Address |
5848 FASHION BLVD STE 110 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84107-6121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548410608 | G Lynn Rasmussen Md PC | Orthopaedic Surgery | 5848 Fashion Blvd Ste 110, Salt Lake City, UT 84107-6121 | 2008-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
| 1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
| 1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
| 1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
| 1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
| 1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
| 1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
| 1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
| 1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
| Find all providers in zip 84107 | ||||
| Taxonomy Code | 207XS0114X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Adult Reconstructive Orthopaedic Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942292446 | Bruce G Evans | Orthopaedic Surgery | 1160 East 3900 South, Suite 5000, Salt Lake City, UT 84124-1275 | 2005-08-19 |
| 1740676394 | Matthew C. Christie | Orthopaedic Surgery | 590 S Wakara Way, Salt Lake City, UT 84108-1200 | 2015-04-10 |
| 1437579893 | Steven Donohoe | Orthopaedic Surgery | 590 S Wakara Way, Salt Lake City, UT 84108-1200 | 2014-04-23 |
| 1548410608 | G Lynn Rasmussen Md PC | Orthopaedic Surgery | 5848 Fashion Blvd Ste 110, Salt Lake City, UT 84107-6121 | 2008-09-25 |
| 1568456242 | Kim C Bertin | Orthopaedic Surgery | 24 S 1100 E, Ste 101, Salt Lake City, UT 84102-1500 | 2005-09-08 |
| 1073505582 | Michael H Bourne | Orthopaedic Surgery | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2005-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083953558 | Russell L Nelson, M.d. PC | Orthopaedic Surgery | 5323 S Woodrow St Ste 200, Murray, UT 84107-5844 | 2013-02-04 |
| 1669416129 | John M Hillyard | Orthopaedic Surgery | 1899 E Mystic Grove Cv, Cottonwood Heights, UT 84093-5509 | 2006-06-15 |
| 1063645554 | Yvonne Potter Fuellenbach | Orthopaedic Surgery | 5848 Fashion Blvd Ste 110, Murray, UT 84107-6121 | 2009-08-31 |
| 1326286972 | Peter G. Larcom Md PC | Orthopaedic Surgery | 5323 South Woodrow Street Suite 200, Murray, UT 84107 | 2009-02-04 |
| 1366460420 | G Lynn Rasmussen | Orthopaedic Surgery | 5848 Fashion Blvd Ste 110, Murray, UT 84107-6121 | 2006-07-17 |
| 1467486795 | Nathan G Momberger | Orthopaedic Surgery | 5848 Fashion Blvd Ste 110, Murray, UT 84107-6121 | 2006-07-11 |
| 1821029869 | Peter G Larcom | Orthopaedic Surgery | 5316 S Woodrow St Ste 200, Murray, UT 84107-5838 | 2006-07-06 |
| City | SALT LAKE CITY |
| Zip Code | 84107 |
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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.