DR. SUSAN P. ETHERIDGE


Address: 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125
Phone: 8012133599

DR. SUSAN P. ETHERIDGE (NPI# 1952480527) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952480527
Entity Type Individual
Full Name DR. SUSAN P. ETHERIDGE
Credential MD
Practice Address 81 N Mario Capecchi Dr
Salt Lake City
UT 84113-1125
Mailing Address Po Box 413021
Salt Lake City
UT 84141-3021
Practice Telephone 8012133599
Practice Fax Number 8012137778
Mailing Telephone 8012133900
Mailing Fax Number 8015853655
Enumeration Date 2006-11-03
Last Update Date 2016-09-28
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207RC0001X Internal Medicine
Specialization: Clinical Cardiac Electrophysiology
8186 AK Allopathic & Osteopathic Physicians
Y 207RC0001X Internal Medicine
Specialization: Clinical Cardiac Electrophysiology
273593-1205 UT Allopathic & Osteopathic Physicians
N 208000000X Pediatrics 8186 AK Allopathic & Osteopathic Physicians
N 208000000X Pediatrics 273593-1205 UT Allopathic & Osteopathic Physicians
N 2080P0202X Pediatrics
Specialization: Pediatric Cardiology
8389 AK Allopathic & Osteopathic Physicians
N 2080P0202X Pediatrics
Specialization: Pediatric Cardiology
273593-120 UT Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
AK 1018632 05

Office Location

Street Address 81 N MARIO CAPECCHI DR
City SALT LAKE CITY
State UT
Zip Code 84113-1125

Providers in the same location

NPI Name Taxonomy Address Enumeration
1922012251 Jeffrey Marvin Dalley Social Worker 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2006-07-29
1255946588 Sarah Elizabeth Roberts Dietitian, Registered 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-09-14
1144835885 Rachel Coffey Social Worker 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-09-10
1457965865 Mallory Caitlin Kidwell Clinic/Center 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-09-02
1063021699 Sara Stevenson Dietitian, Registered 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-07-29
1780292318 Katherine Ruesch Nurse Practitioner 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-07-20
1124646062 Nathaniel Edward Hayward Student in an Organized Health Care Education/Training Program 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-07-07
1780209544 Paul Clark Bluth Student in an Organized Health Care Education/Training Program 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-06-08
1477177939 Kristen Wong Genetic Counselor, MS 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-06-01
1891316170 Brianna Dougall Registered Nurse 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-04-28
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1386111060 Melissa Marie Dixon Psychologist Primary Children's Hospital Outpatient Services, 81 South Mario Capecchi Drive, Salt Lake City, UT 84113 2018-10-31
1366965618 Ashley Stuart Psychologist 44 North Mario Capecchi Drive, Salt Lake City, UT 84113 2017-07-19
1487945135 Justin C Wheeler Pediatrics 81 N Mario Capecchi Dr Fl 4, Salt Lake City, UT 84113 2011-04-29
1154612117 Dana Boucek Pediatrics 100 North Mario Capecchi Dr., Primary Children's, Salt Lake City, UT 84113 2011-04-26
1285959502 Anna Katherine Eyre Ermarth Pediatrics 81 Mario Capecchi, Salt Lake City, UT 84113 2010-03-30
1457682072 Elizabeth K Cho Nurse Practitioner 100 North Mario Cappechi Dr., Salt Lake City, UT 84113 2010-01-21
1528290848 Nancy Crandell Brown Nurse Practitioner 100 North Mario Cappechi Drive, Salt Lake City, UT 84113 2009-08-20
1679708481 Primary Children's Medical Center General Acute Care Hospital 100 No. Mario Capecchi Drive, Salt Lake, UT 84113 2009-05-22
1467697235 Tara Hook Physical Therapist 100 North Mario Capecchi Dr, Salt Lake City, UT 84113 2008-12-09
1144474768 Jennifer K Workman Pediatrics 100 N Mario Capecchi Drive, Pediatric Crtical Care, Primary Children's Hospital, Salt Lake City, UT 84113 2008-11-10
Find all providers in zip 84113

Taxonomy Information

Taxonomy Code 207RC0001X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Clinical Cardiac Electrophysiology

Taxonomy Definition

A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1851795652 University of Utah Adult Services Internal Medicine 50 North Medical Drive, Salt Lake City, UT 84132 2014-10-22
1164842415 Karnika Ayinapudi Internal Medicine 30 N 1900 E Rm 4a100, Salt Lake City, UT 84132-0002 2014-04-24
1992967335 Nischala Nannapaneni Internal Medicine 1160 E 3900 S Ste 2000, Salt Lake City, UT 84124-1236 2008-06-26
1518048305 Travis Scott Wall Internal Medicine 50 N Medical Dr, Salt Lake City, UT 84132-0001 2006-10-18
1790866580 Roger A. Freedman Internal Medicine 100 N Medical Dr, Salt Lake City, UT 84113-1103 2006-10-18

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1497078786 Seongwook Han Internal Medicine 1055 N 500 W, Ste 101, Provo, UT 84604-3305 2010-03-01
1952569931 Yonathan Melman Internal Medicine 4403 Harrison Blvd, Ste 3450, Ogden, UT 84403-3271 2008-05-27
1417025628 Michael Cutler Internal Medicine 5169 S Cottonwood St, Ste 510, Murray, UT 84107-6767 2006-12-04
1366413924 John H. Jentzer Internal Medicine 1380 E Medical Center Dr, Suite 1500, St George, UT 84790-2123 2006-01-31

Competitor

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City SALT LAKE CITY
Zip Code 84113

Improve Information

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Dataset Information

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.

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