PEDIATRIC ORTHOPEDIC ASSOCIATES (NPI# 1659488799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659488799 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC ORTHOPEDIC ASSOCIATES |
| Practice Address |
100 Mario Capecchi Dr Salt Lake City UT 84112-8924 |
| Mailing Address |
Po Box 58886 Salt Lake City UT 84158-0886 |
| Practice Telephone | 8015883900 |
| Mailing Telephone | 8012138300 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2008-10-16 |
| Authorized Official Name | ALAN KENDRICK STOTTS (DEPARTMENT CHAIR) |
| Authorized Official Telephone | 8015883900 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians | ||
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| Y | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | WYOMING MEDICIAD | 122394100 | 01 |
| CO | COLORADO MEDICAID | 22074538 | 01 |
| ID | IDAHO MEDICAID | 806656500 | 01 |
| Street Address |
100 MARIO CAPECCHI DR |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84112-8924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033111810 | Andrew Gerald Smith | Legal Medicine | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2005-08-11 |
| 1235535485 | Ihc Health Services Inc | Clinic/Center | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-11-17 |
| 1508262833 | Aimee Brierley | Occupational Therapist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-11-13 |
| 1801290986 | Jeffery Zobell | Pharmacist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-10-17 |
| 1336542778 | Bevan Jensen | Pharmacist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-09-30 |
| 1699183152 | Kristina Rogers | Dentist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-07-29 |
| 1548677297 | Stephanie Eva Wisniewski | Speech-Language Pathologist | 100 Mario Capecchi Dr, Primary Children's Rehab, Salt Lake City, UT 84113-1103 | 2014-07-15 |
| 1184044877 | Adam Wesley Dell | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-04-21 |
| 1225456718 | Bhanu Muniyappa | Pediatrics | 100 Mario Capecchi Dr, Pediatrics Residency Program, Salt Lake City, UT 84113-1103 | 2014-04-01 |
| 1265850952 | Kristina Gulliver | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508484023 | Courtney Hook | Student in an Organized Health Care Education/Training Program | 1860 E 250 S Hper East, Room 208, Salt Lake City, UT 84112 | 2020-07-10 |
| 1235792839 | Dylan Lamb | Rehabilitation Practitioner | 1850 S. 260 E, Salt Lake City, UT 84112 | 2019-04-18 |
| 1740787407 | David Bradley Patch | Student in an Organized Health Care Education/Training Program | University of Utah Hospital Dental Clinic #7, 50 N. Medical Dr., Salt Lake City, UT 84112 | 2018-04-10 |
| 1962949586 | Gina Whitehead | Nurse Practitioner | 10 South 2000 East, Salt Lake City, UT 84112 | 2017-01-20 |
| 1316493117 | Dana Friske | Specialist/Technologist | 290 S 1850 E, Room 103, Salt Lake City, UT 84112 | 2016-08-31 |
| 1548612435 | Frances Millett Johnson | Nurse Practitioner | 555 South Foothill Blvd, Suite 301, Salt Lake City, UT 84112 | 2016-07-05 |
| 1679920904 | Jason Lippman | Family Medicine | 555 S. Foothill Blvd., Ste. 301, Salt Lake City, UT 84112 | 2016-05-17 |
| 1447604335 | Joseph Mcbeth | Specialist/Technologist | 580 S. Guardsman Way, Salt Lake City, UT 84112 | 2016-04-18 |
| 1104213636 | Cameron Critchfield | Student in an Organized Health Care Education/Training Program | 26 South 2000 East, Suite 5900, Salt Lake City, UT 84112 | 2015-04-22 |
| 1942697933 | Jennifer Rose | Dentist | 50 N Medical Dr, University Hospital, Salt Lake City, UT 84112 | 2015-04-17 |
| Find all providers in zip 84112 | ||||
| Taxonomy Code | 2085P0229X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Pediatric Radiology |
| A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720198716 | William D. Winters | Radiology | 100 No Mario Capecchi Dr., Salt Lake City, UT 84113 | 2006-08-30 |
| 1215940465 | Karin L. Hoeg | Radiology | 100 No. Mario Capecchi Dr., Salt Lake City, UT 84113 | 2006-08-15 |
| 1053664680 | Ihc Health Services Inc | Radiology | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2012-10-19 |
| 1730394131 | Ryan W. Arnold | Radiology | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2007-05-11 |
| 1083739270 | Henry J Baskin Jr. | Radiology | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2007-03-20 |
| 1790875300 | Kathleen Ann Murray | Radiology | Fairfax Road At Virginia Street, Shriners Hosptials for Children, Salt Lake City, UT 84103-4399 | 2006-10-13 |
| 1447351978 | Giosue Peter Feola | Radiology | 100 N Medical Dr, Salt Lake City, UT 84113-1103 | 2006-09-26 |
| 1063513596 | Constance K Maves | Radiology | 100 N Medical Dr, Salt Lake City, UT 84113-1103 | 2006-09-26 |
| 1154422681 | Gary L Hedlund | Radiology | 100 N Medical Dr, Salt Lake City, UT 84113-1103 | 2006-09-26 |
| 1306940739 | Kevin R Moore | Radiology | 100 N Medical Dr, Salt Lake City, UT 84113-1103 | 2006-09-07 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84112 |
Please comment or provide details below to improve the information on PEDIATRIC ORTHOPEDIC ASSOCIATES.
| 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.