MS. LARISSA BEYERLEIN (NPI# 1902110232) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902110232 |
| Entity Type | Individual |
| Full Name | MS. LARISSA BEYERLEIN |
| Credential | M.D. |
| Practice Address |
295 Chipeta Way Department of Pediatric Emergency Medicine Salt Lake City UT 84158 |
| Mailing Address |
295 Chipeta Way, Suite 200 Pediatric Emergency Medicine Salt Lake City UT 84158 |
| Practice Telephone | 8015877436 |
| Practice Fax Number | 8015877455 |
| Mailing Telephone | 8015877436 |
| Mailing Fax Number | 8015877455 |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2015-10-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0204X |
Pediatrics Specialization: Pediatric Emergency Medicine |
8637381-1205 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
295 CHIPETA WAY DEPARTMENT OF PEDIATRIC EMERGENCY MEDICINE |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84158 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891751384 | Emily A Thorell | Pediatrics | 295 Chipeta Way, 2s010, Salt Lake City, UT 84108-1287 | 2006-04-24 |
| 1760851075 | Jacob Kean | Speech-Language Pathologist | 295 Chipeta Way, Williams Building, Rm 1n490, Salt Lake City, UT 84108 | 2015-09-16 |
| 1215293667 | Reena Patel Tam | Pediatrics | 295 Chipeta Way, Salt Lake City, UT 84108-1287 | 2012-04-10 |
| 1437447190 | Tiffany Kae Profsky | Nurse Practitioner | 295 Chipeta Way, Salt Lake City, UT 84108-1287 | 2011-07-15 |
| 1629303839 | Caroline Hagedorn | Nurse Practitioner | 295 Chipeta Way, Salt Lake City, UT 84108-1287 | 2009-10-05 |
| 1245490424 | Eric Wallace Glissmeyer | General Acute Care Hospital | 295 Chipeta Way, Salt Lake City, UT 84108-1287 | 2008-06-11 |
| 1295995694 | France A Davis II | Physician Assistant | 295 Chipeta Way, Salt Lake City, UT 84108-1287 | 2008-06-10 |
| 1669631826 | Tamara Elena Pool | Pediatrics | 295 Chipeta Way, Salt Lake City, UT 84108-1287 | 2008-06-03 |
| 1811164031 | Shrena Patel | Pediatrics | 295 Chipeta Way, Salt Lake City, UT 84108-1287 | 2008-05-15 |
| 1225202260 | Allison Anne Keller | Emergency Medicine | 295 Chipeta Way, Salt Lake City, UT 84108-1220 | 2008-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629230958 | Mountain West Cardiovascular Associates | Specialist | 5169 Cottonwood St, Suite B620, Murray, UT 84158 | 2008-06-27 |
| 1124084140 | Harriet W Hopf | Anesthesiology | 50 N Medical Dr, U of U Department of Anesthesiology, Salt Lake City, UT 84158 | 2006-04-26 |
| Taxonomy Code | 2080P0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Emergency Medicine |
| A pediatrician who has special qualifications to manage emergencies in infants and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023545670 | Natalie Justine Tedford | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2017-05-15 |
| 1437513926 | University of Utah Pediatric Services | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-04-11 |
| 1538523675 | University of Utah Pediatric Acuity Care | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-04-05 |
| 1255795399 | University of Utah Pediatric Services | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-04-05 |
| 1811350325 | Jonathan Robert Eisenberg | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2016-04-01 |
| 1295121184 | Tiana Monostory | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2015-04-08 |
| 1568889541 | Cheryl Yang | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2014-03-27 |
| 1811230378 | Sydney Ryan | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2013-04-03 |
| 1245524651 | Pediatric Emergency Sedation Service | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2011-06-02 |
| 1184915217 | Rachel Elizabeth Whitney | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2011-04-24 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84158 |
Please comment or provide details below to improve the information on MS. LARISSA BEYERLEIN.
| 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.