JACQUELINE PANKO (NPI# 1366644478) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366644478 |
| Entity Type | Individual |
| Full Name | JACQUELINE PANKO |
| Credential | M.D. |
| Practice Address |
3845 W 4700 S 2nd Floor Taylorsville UT 84129-3454 |
| Practice Telephone | 8019663376 |
| Mailing Telephone | 8019663376 |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2011-12-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | BP9563190 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
3845 W 4700 S 2ND FLOOR |
| City | TAYLORSVILLE |
| State | UT |
| Zip Code | 84129-3454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508844853 | Nathan C Mckellar | Family Medicine | 3845 W 4700 S, Taylorsville, UT 84129-3454 | 2006-01-06 |
| 1639710411 | Ashley Margaret May | Occupational Therapist | 3845 W 4700 S, Taylorsville, UT 84129-3454 | 2019-10-03 |
| 1194379834 | Seth Michael Aure Pratt | Occupational Therapist | 3845 W 4700 S, Taylorsville, UT 84129-3454 | 2019-07-31 |
| 1215597786 | Michelle L Winter | Family Medicine | 3845 W 4700 S, Taylorsville, UT 84129-3454 | 2019-06-17 |
| 1184281107 | Shannon Lee Higginson | Physical Therapist | 3845 W 4700 S, Taylorsville, UT 84129-3454 | 2019-05-24 |
| 1972043180 | Arielle Myers | Speech-Language Pathologist | 3845 W 4700 S, Taylorsville, UT 84129-3454 | 2017-03-07 |
| 1396285573 | Ariel Hyams | Speech-Language Pathologist | 3845 W 4700 S, Taylorsville, UT 84129-3454 | 2017-03-07 |
| 1285187617 | Kimberly Milam | Physical Therapist | 3845 W 4700 S, Second Floor, Taylorsville, UT 84129-3454 | 2016-08-02 |
| 1255796272 | Alison Young Sleight | Occupational Therapist | 3845 W 4700 S, Taylorsville, UT 84129-3454 | 2015-12-17 |
| 1295119402 | Destiny Lyn Breaux | Physical Therapist | 3845 W 4700 S, Taylorsville, UT 84129-3454 | 2015-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891140331 | Caring for Kearns | Social Worker | 5525 S 4015 W, Suite #207 A & B, Taylorsville, UT 84129 | 2016-05-03 |
| 1386014116 | Rusty Scott Burns | Physician Assistant | 4745 South 3200 West, Oquirrh View Clinic, Taylorsville, UT 84129 | 2015-10-06 |
| 1013398817 | Clifford Simpson | Counselor | 4897 S Avant Cir, Taylorsville, UT 84129 | 2015-06-17 |
| 1912328576 | Heather Jenkins | Substance Abuse Rehabilitation Facility | 6200 South 3809 West, Kearns, UT 84129 | 2013-12-30 |
| 1184981201 | Intermountain Community Supports and Services, LLC | In Home Supportive Care | 5104 Heritage Cove, Taylorsville, UT 84129 | 2012-04-13 |
| 1093039521 | Chad Alan Spain | Family Medicine | 3745 West 4700 South, Family Practice, Taylorsville, UT 84129 | 2010-03-26 |
| 1396068342 | Lindsay Helena Wilson | Dermatology | 3845 West 4700 South, Intermountain Healthcare Taylorsville Clinic, Taylorsville, UT 84129 | 2010-03-04 |
| 1962962407 | Craig J Campbell Dpm PC | Durable Medical Equipment & Medical Supplies | 5255 S 4015 W, #140, Salt Lake City, UT 84129 | 2019-03-21 |
| 1851866735 | Katie Nicholls | Physician Assistant | 4745 S 3200 W, Taylorsville, UT 84129 | 2018-10-08 |
| 1962829374 | Spencer Tingey | Family Medicine | 3730 W 4700 S, Taylorsville, UT 84129 | 2014-03-24 |
| Find all providers in zip 84129 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396068342 | Lindsay Helena Wilson | Dermatology | 3845 West 4700 South, Intermountain Healthcare Taylorsville Clinic, Taylorsville, UT 84129 | 2010-03-04 |
| 1710384367 | Ihc Health Services Inc | Dermatology | 3845 W 4700 S, Taylorsville, UT 84129-3454 | 2014-11-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245863893 | Central Utah Dermatology | Dermatology | 861 N Main, Richfield, UT 84701 | 2020-02-21 |
| 1548810401 | Smart & Gibbs | Dermatology | 3200 W Clubhouse Dr Ste 100, Lehi, UT 84043-4325 | 2019-09-12 |
| 1043874332 | Waymore Shade LLC | Dermatology | 451 S Main St Ste 1, Springville, UT 84663-2293 | 2019-04-23 |
| 1598261869 | Tuttle Dermatology PC | Dermatology | 617 E Riverside Dr Ste 103, St George, UT 84790-8049 | 2018-04-04 |
| 1770099251 | Ihc Health Services Inc | Dermatology | 395 W Bulldog Blvd Ste 604, Provo, UT 84604-3331 | 2017-12-20 |
| 1417467986 | Red Ledges Dermatology Pllc | Dermatology | 1449 N 1400 W Ste 22, St George, UT 84770-5237 | 2017-10-10 |
| 1649724139 | University of Utah Adult Services | Dermatology | 165 N. University Ave. Farmington, Farmington, UT 84025 | 2016-08-12 |
| 1861861155 | Brent H. Goodsell, Do | Dermatology | 162 S 1100 E, American Fork, UT 84003-2817 | 2015-09-17 |
| 1912316654 | Jeanna Tachiki Ryan | Dermatology | 243 E 6100 S, Murray, UT 84107-7302 | 2014-08-07 |
| 1659785889 | Dana Rice | Dermatology | 6095 S Fashion Blvd Ste 270, Murray, UT 84107-7387 | 2014-06-16 |
| Find all providers with the same taxonomy | ||||
| City | TAYLORSVILLE |
| Zip Code | 84129 |
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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.