DR. CHARLES R CARRASCO (NPI# 1730126475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730126475 |
| Entity Type | Individual |
| Full Name | DR. CHARLES R CARRASCO |
| Credential | M.D. |
| Practice Address |
5444 Green St Murray UT 84123-5632 |
| Practice Telephone | 8012862812 |
| Practice Fax Number | 8012625721 |
| Mailing Telephone | 8012622647 |
| Mailing Fax Number | 8012623897 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2012-09-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
M-4291 | ID | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
162938-1205 | UT | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
162938-1205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | D5611 | 05 |
| Street Address |
5444 GREEN ST |
| City | MURRAY |
| State | UT |
| Zip Code | 84123-5632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639175144 | Jonathan Scott Silverstein | Radiology | 5444 Green St, Murray, UT 84123-5632 | 2005-06-21 |
| 1730436890 | James Moyes | Physician Assistant | 5444 Green St, Murray, UT 84123-5632 | 2012-08-08 |
| 1376823138 | Karen King | Physician Assistant | 5444 Green St, Murray, UT 84123-5632 | 2011-08-25 |
| 1457630642 | Trent Russell | Physician Assistant | 5444 Green St, Murray, UT 84123-5632 | 2011-08-05 |
| 1568756393 | Nicole Erkelens | Nurse Practitioner | 5444 Green St, Murray, UT 84123-5632 | 2011-06-09 |
| 1821240243 | Joseph Lawrence Sartori | Physician Assistant | 5444 Green St, Murray, UT 84123-5632 | 2008-10-16 |
| 1710133632 | Angie A Barney | Radiologic Technologist | 5444 Green St, Murray, UT 84123-5632 | 2008-08-12 |
| 1851565006 | Christopher M Roach | Radiology | 5444 Green St, Murray, UT 84123-5632 | 2008-04-18 |
| 1265624035 | Talmage Legrand Shill | Radiology | 5444 Green St, Murray, UT 84123-5632 | 2007-08-15 |
| 1477745453 | Darryn John Detmers | Radiologic Technologist | 5444 Green St, Murray, UT 84123-5632 | 2007-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679186837 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 5792 South Redwood Road, Taylorsville, UT 84123 | 2020-08-27 |
| 1164040614 | Mark E Hutchinson | Counselor | 5047 S Galleria Drive, Murray, UT 84123 | 2020-07-10 |
| 1396259321 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 4082 South Redwood Road, West Valley Road, UT 84123 | 2017-11-29 |
| 1083131890 | Kelli Mcstotts | Counselor | 5689 S. Redwood Road, Taylorsville, UT 84123 | 2017-08-23 |
| 1740706571 | Laura B Ellsworth | Case Manager/Care Coordinator | 5667 So. Redwood Road, 6b, Salt Lake City, UT 84123 | 2017-08-14 |
| 1790214120 | Integrated Autism Therapies | Behavioral Analyst | 5984 S. Susquehanna, Murray, UT 84123 | 2017-06-08 |
| 1083163885 | Michael John Flint | Counselor | 5861 South Redwood Road, #24, Taylorsville, UT 84123 | 2016-09-22 |
| 1548716236 | Andres Ramos | Licensed Psychiatric Technician | 697 West 4170 South, Murray, UT 84123 | 2016-09-01 |
| 1467807040 | Sheryl R Schindler | Counselor | 5770 South 1550 West, Bldg G, Primary Children's Counseling Center, Taylorsville, UT 84123 | 2016-05-02 |
| 1730562141 | Megan Merica Snarr | Dentist | 597 West 5300 South, Murray, UT 84123 | 2015-07-02 |
| Find all providers in zip 84123 | ||||
| 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 |
|---|---|---|---|---|
| 1679180509 | Provas of Provo | Radiology | 320 River Park Dr Ste 215, Provo, UT 84604-6065 | 2020-09-24 |
| 1558905398 | Wasatch Vascular Center LLC | Radiology | 3702 S State St Ste 103, Salt Lake City, UT 84115-5096 | 2019-11-05 |
| 1831662311 | Cache Valley Vein | Radiology | 565 W 465 N Ste 130, Providence, UT 84332-4802 | 2019-01-07 |
| 1568965697 | Comprehensive Interventional Care Centers, Pllc | Radiology | 4624 S Holladay Blvd Ste 202, Salt Lake City, UT 84117-7168 | 2018-03-15 |
| 1740608272 | Michael Max Adam | Radiology | 1055 N 500 W Ste 112, Provo, UT 84604-3305 | 2014-04-02 |
| 1356630073 | Claire Kaufman | Radiology | Medical Center 30 N 1900 E, Salt Lake City, UT 84132-0001 | 2011-04-04 |
| 1982821690 | Edward John Sarver | Radiology | 5395 Old Post Rd, Ogden, UT 84403-4346 | 2007-04-20 |
| 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 |
| 1790736130 | St. George Radiology Inc. | Radiology | 1308 E 900 S, St George, UT 84790-8520 | 2006-05-12 |
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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.