DERMATOLOGY DIVISION UNIVERSITY OF UTAH MEDICAL CENTER (NPI# 1922096114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922096114 |
| Entity Type | Organization |
| Organization Name | DERMATOLOGY DIVISION UNIVERSITY OF UTAH MEDICAL CENTER |
| Other Organization Name | U-U DERMATOLOGY DIVISION SCHOOL OF MEDICINE |
| Practice Address |
50 N Medical Dr Salt Lake City UT 84132-0001 |
| Mailing Address |
Po Box 35145 Lb 3208 Seattle WA 98124-5145 |
| Practice Telephone | 8015812955 |
| Practice Fax Number | 8015876346 |
| Mailing Telephone | 8015876340 |
| Mailing Fax Number | 8015876346 |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2019-12-16 |
| Authorized Official Name | MS. ALICIA PIERSON (BILLING MANAGER) |
| Authorized Official Telephone | 8015876338 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207K00000X | Allergy & Immunology | 1617461205 | UT | Allopathic & Osteopathic Physicians |
| N | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
1617461205 | UT | Allopathic & Osteopathic Physicians |
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
1617461205 | UT | Allopathic & Osteopathic Physicians |
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
1617461205 | UT | Allopathic & Osteopathic Physicians |
| N | 207NI0002X |
Dermatology Specialization: Clinical & Laboratory Dermatological Immunology |
1617461205 | UT | Allopathic & Osteopathic Physicians |
| N | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
1617461205 | UT | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
1617461205 | UT | Allopathic & Osteopathic Physicians |
| Y | 207N00000X | Dermatology | 1617461205 | UT | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| U-U Dermatology Division School of Medicine | Doing Business As Name - Organization |
| 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 | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548680184 | West Valley Dermatology | Dermatology | 3465 S Pioneer Pkwy, Suite 1, Salt Lake City, UT 84120-2076 | 2014-04-22 |
| 1558782276 | Margaret Maria Cocks | Dermatology | 30 N 1900 E Rm 4a330, Salt Lake City, UT 84132-0002 | 2013-12-23 |
| 1588007520 | Blake Patrick Sampson | Dermatology | University of Utah Department of Dermatology, 30 N 1900 E, Salt Lake City, UT 84132-0001 | 2013-04-09 |
| 1689943219 | Richard H Odell Md PC | Dermatology | 1345 E 3900 S. Suite 110, Salt Lake City, UT 84124 | 2011-12-28 |
| 1770779050 | Keith Duffy | Dermatology | University of Utah Dept Of, 50 N Medical Dr, Salt Lake City, UT 84112-1102 | 2007-09-19 |
| 1255543971 | Norman Everett Bystol | Dermatology | 4021 S 700 East, Suite 300 Comp Health, Salt Lake City, UT 84107 | 2007-05-04 |
| 1740346071 | Rosemary Ann Deshazo | Dermatology | 50 N 1900 E, Univ of Utah Internal Medicine Dept, Som 4c104, Salt Lake City, UT 84132-0001 | 2006-12-29 |
| 1215999875 | Richard H Odell | Dermatology | 1345 E 3900 S Ste 110, Salt Lake City, UT 84124-4403 | 2006-04-06 |
| 1659350049 | Don L Reese | Dermatology | 999 Murray Holladay Rd, Suite 207, Salt Lake City, UT 84117-4901 | 2006-01-13 |
| 1407851595 | Wendy L Matis | Dermatology | 710 E 200 S, Ste 1b, Salt Lake City, UT 84102-2265 | 2005-06-16 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84132 |
Please comment or provide details below to improve the information on DERMATOLOGY DIVISION UNIVERSITY OF UTAH MEDICAL CENTER.
| 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.