UNIVERSITY OF UTAH VASCULAR NEUROLOGY DEPARTMENT OF UNIVERSITY (NPI# 1538448774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538448774 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF UTAH VASCULAR NEUROLOGY DEPARTMENT OF UNIVERSITY |
| Practice Address |
50 N Medical Dr Salt Lake City UT 84132-0001 |
| Mailing Address |
Po Box 413027 Salt Lake City UT 84141-3027 |
| Practice Telephone | 8015856387 |
| Mailing Telephone | 8012133900 |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2011-08-05 |
| Authorized Official Name | STEFAN M PULST (DEPARTMENT CHAIR) |
| Authorized Official Telephone | 8015856387 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084V0102X |
Psychiatry & Neurology Specialization: Vascular Neurology |
Allopathic & Osteopathic Physicians |
| Street Address |
50 N MEDICAL DR |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84132-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477555696 | Yaw Ababio Boateng | Internal Medicine | 50 N Medical Dr, Salt Lake City, UT 84132-0100 | 2005-06-01 |
| 1073114864 | Stephanie Bevill | Registered Nurse | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-11-06 |
| 1609477801 | Justin Larson | Physical Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-11-04 |
| 1366042467 | Kirsty Aleah Vannoy | Occupational Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-10-28 |
| 1629675673 | Erica Kueneman | Nurse Practitioner | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-10-02 |
| 1487266680 | Michelle A Barker | Physical Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-08-19 |
| 1770195943 | Lisa M Schaeffer | Nurse Practitioner | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-08-19 |
| 1194336289 | Michelle Rios | Physical Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-08-12 |
| 1932710027 | Tanner Ladsten | Physical Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-08-12 |
| 1578174660 | Rachel Sette | Occupational Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-08-12 |
| Find all providers in the same location | ||||
| 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 | 2084V0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Vascular Neurology |
| Vascular Neurology is a subspecialty in the evaluation, prevention, treatment and recovery from vascular diseases of the nervous system. This subspecialty includes the diagnosis and treatment of vascular events of arterial or venous origin from a large number of causes that affect the brain or spinal cord such as ischemic stroke, intracranial hemorrhage, spinal cord ischemia and spinal cord hemorrhage. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629394556 | Lee Shan Chung | Psychiatry & Neurology | 175 N Medical Dr East, Salt Lake City, UT 84132-0001 | 2010-04-16 |
| 1487897898 | Adam Helme De Havenon | Psychiatry & Neurology | 175 N Medical Dr, East 5th Floor, Salt Lake City, UT 84132-5901 | 2009-04-15 |
| 1437376571 | Vivek K Reddy | Psychiatry & Neurology | 175 N Medical Drive East, Salt Lake City, UT 84132-5705 | 2007-04-19 |
| 1902268626 | Piotr Tomasz Tekiela | Psychiatry & Neurology | 175 N Medical Drive, Salt Lake City, UT 84132-0001 | 2016-03-22 |
| 1053568204 | Edgar Jorge Garcia-morales | Psychiatry & Neurology | 5121 Cottonwood St, Neurovascular Medicine 4th Floor Tower . Murray, Salt Lake City, UT 84107-5701 | 2008-08-19 |
| 1467463489 | Intermountain Stroke Center, Inc. | Psychiatry & Neurology | 5292 College Dr, Suite 204, Salt Lake City, UT 84123-2672 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750516241 | Kyle Stanley Hobbs | Psychiatry & Neurology | 5171 S Cottonwood St Ste 810, Murray, UT 84107 | 2009-05-27 |
| 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.