DR. SHANE NICHOLAS WEBER (NPI# 1467865329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467865329 |
| Entity Type | Individual |
| Full Name | DR. SHANE NICHOLAS WEBER |
| Credential | D.O. |
| Practice Address |
30 N 1900 E Rm 1a07 Salt Lake City UT 84132-0002 |
| Practice Telephone | 8015817553 |
| Mailing Telephone | 8015817553 |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2019-06-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
5101021222 | MI | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
11085898-1204 | UT | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 18101 Oakwood Blvd, Dearborn, MI 481244089 | 3134362583 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205120920 | Shane Michael Weber | Physical Therapist | 1674 15th Street West, Suite #1, Dickinson, ND 58601 | 2011-05-31 |
| 1326522038 | Shane Weber | Physical Therapy Assistant | 1902 59th St W, Bradenton, FL 34209-4602 | 2018-09-18 |
| Street Address |
30 N 1900 E RM 1A07 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84132-0002 |
| 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 | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558905398 | Wasatch Vascular Center LLC | Radiology | 3702 S State St Ste 103, Salt Lake City, UT 84115-5096 | 2019-11-05 |
| 1568965697 | Comprehensive Interventional Care Centers, Pllc | Radiology | 4624 S Holladay Blvd Ste 202, Salt Lake City, UT 84117-7168 | 2018-03-15 |
| 1356630073 | Claire Kaufman | Radiology | Medical Center 30 N 1900 E, Salt Lake City, UT 84132-0001 | 2011-04-04 |
| 1821154121 | Ryan Gene O'hara | Radiology | University of Utah Dept of Radiology, 30n. 1900e #1a071, Salt Lake City, UT 84132-6100 | 2006-12-29 |
| 1386731339 | Franklin J. Miller Jr. | Radiology | Dept Radiology University of Utah 50 N Medical Drive, 1a71, Salt Lake City, UT 84132-0001 | 2006-10-09 |
| 1972078723 | Physician Medical Group | Radiology | 4624 S Holladay Blvd Ste 202, Salt Lake City, UT 84117-7168 | 2018-10-08 |
| 1104361591 | Genesis Vascular of Salt Lake | Radiology | 6321 S Redwood Rd, Suite 102, Salt Lake City, UT 84123-6798 | 2016-12-21 |
| 1457755258 | University of Utah Adult Services | Radiology | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2014-10-22 |
| 1184044190 | Kevin Maxwell | Radiology | 1200 E 3900 S, Salt Lake City, UT 84124-1300 | 2014-04-17 |
| 1316203797 | Jared Randall Garrett | Radiology | 30 N 1900 E Rm 1a071, Salt Lake City, UT 84132-0002 | 2012-04-10 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84132 |
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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.