UNIVERSITY OF UTAH PEDIATRIC ACUITY CARE (NPI# 1376907410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376907410 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF UTAH PEDIATRIC ACUITY CARE |
| Other Organization Name | RIVERTON HOSPITAL - PEDIATRIC CRITICAL CARE |
| Practice Address |
3741 W 12600 S Riverton UT 84065-7215 |
| Mailing Address |
Po Box 841450 Los Angeles CA 90084-1450 |
| Practice Telephone | 8015876336 |
| Mailing Telephone | 8012133900 |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2020-05-20 |
| Authorized Official Name | EDWARD CLARK (DEPARTMENT CHAIR) |
| Authorized Official Telephone | 8015876336 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | UNIVERSITY OF UTAH PEDIATRIC ACUITY CARE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Riverton Hospital - Pediatric Critical Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851898365 | University of Utah Pediatric Acuity Care | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2018-04-11 |
| 1619325131 | University of Utah Pediatric Acuity Care | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-05-25 |
| 1538523675 | University of Utah Pediatric Acuity Care | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-04-05 |
| 1770947814 | University of Utah Pediatric Acuity Care | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-04-05 |
| 1558723445 | University of Utah Pediatric Acuity Care | Psychiatry & Neurology | 501 S Chipeta Way, Salt Lake City, UT 84108-1222 | 2016-03-22 |
| 1891156741 | University of Utah Pediatric Acuity Care | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-03-18 |
| Street Address |
3741 W 12600 S |
| City | RIVERTON |
| State | UT |
| Zip Code | 84065-7215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982647145 | Daniel Louis Chadwell | Audiologist | 3741 W 12600 S, Intermountain Riverton Hospital, Riverton, UT 84065-7215 | 2006-06-14 |
| 1023619533 | Carson Chandler | Physical Therapist | 3741 W 12600 S, Riverton, UT 84065-7215 | 2020-11-03 |
| 1245885664 | Jessica Marie Roestenburg | Occupational Therapist | 3741 W 12600 S, Riverton, UT 84065 | 2019-08-02 |
| 1366902306 | Megan Nalder | Speech-Language Pathologist | 3741 W 12600 S, Riverton, UT 84065-7215 | 2019-03-25 |
| 1205367836 | Jessica Posch | Speech-Language Pathologist | 3741 W 12600 S, Riverton, UT 84065-7215 | 2017-03-24 |
| 1013465921 | Cambry Kaylor | Occupational Therapist | 3741 W 12600 S, Riverton, UT 84065-7215 | 2016-09-20 |
| 1952752008 | Shelly Hardy | Physical Therapist | 3741 W 12600 S, Riverton, UT 84065-7215 | 2016-06-29 |
| 1114378288 | Intermountain Healthcare | Clinic/Center | 3741 W 12600 S, Riverton, UT 84065-7215 | 2016-06-29 |
| 1508215807 | Jordan Wood | Physical Therapist | 3741 W 12600 S, Riverton, UT 84065-7215 | 2016-06-07 |
| 1043671985 | University of Utah Pediatric Services | Pediatrics | 3741 W 12600 S, Riverton, UT 84065-7215 | 2016-03-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972248 | William Lance Andersen | Pharmacist | 1202 W 12600 W, Riverton, UT 84065 | 2020-11-02 |
| 1275172678 | Dentists of Riverton, LLP | Dentist | 4531 W. Partridgehill Lane, Suite F-110, Riverton, UT 84065 | 2020-01-02 |
| 1194201467 | Patrick Kunkel | Dentist | 12569 2700 W, #100, Riverton, UT 84065 | 2018-07-19 |
| 1790274546 | Harmon City Inc | Pharmacy | 13330 South Kestrel Range Road, Riverton, UT 84065 | 2018-05-08 |
| 1386147767 | Richard Hayes Johnston | Counselor | 3740 S Market Center Dr #1200, Riverton, UT 84065 | 2018-03-13 |
| 1023537156 | Brenda Fuell | Dental Hygienist | 12959 South Picket Fence Lane, Riverton, UT 84065 | 2017-09-09 |
| 1407373426 | Bethany Marie Breck | Counselor | 3740 S Market Center Drive, #1200, Riverton, UT 84065 | 2017-08-30 |
| 1952848509 | Renaissance Ranch Bluffdale Women's Program | Substance Abuse Rehabilitation Facility | 2356 Thunderhead Way, Bluffdale, UT 84065 | 2017-01-20 |
| 1053856229 | Bradford Scott Bentley Jr. | Physical Therapist | 3741 W 12600 S, Ste 100, Riverton, UT 84065 | 2016-12-27 |
| 1194273524 | New Horizon | Preferred Provider Organization | 1420 W 12600 Sputh, Draper, UT 84065 | 2016-09-14 |
| Find all providers in zip 84065 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942642541 | Elizabeth Quigley | Pediatrics | 515 E 100 S Ste 200, Salt Lake City, UT 84102-2095 | 2013-07-23 |
| 1144474768 | Jennifer K Workman | Pediatrics | 100 N Mario Capecchi Drive, Pediatric Crtical Care, Primary Children's Hospital, Salt Lake City, UT 84113 | 2008-11-10 |
| 1588634729 | William Bradley Poss | Pediatrics | 295 E Chipeta Way, Salt Lake City, UT 84108-1287 | 2006-01-23 |
| 1174039614 | Ihc Health Services Inc | Pediatrics | 1034 N 500 W, Provo, UT 84604-3380 | 2017-12-20 |
| 1174056758 | Andrew Daniel Fontes | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2017-04-10 |
| 1457883449 | Lauren Burgunder | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2017-03-30 |
| 1891156741 | University of Utah Pediatric Acuity Care | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-03-18 |
| 1669866133 | Angela Coker | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84108 | 2015-03-23 |
| 1801216957 | Kevin Hummel | Pediatrics | 30 N 1900 E # 1c412, Salt Lake City, UT 84132-9760 | 2014-04-16 |
| 1972842813 | Tighe Nicholas Marrone | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2013-02-13 |
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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.