Brenton Waters (NPI# 1619402732, PAC ID# 5496024333) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1619402732 |
| PAC ID by PECOS | 5496024333 |
| Professional Enrollment ID | I20170707002223 |
| Full Name | Brenton Waters |
| Organization Legal Name | UNIVERSITY OF UTAH ADULT SERVICES |
| Address |
2000 Circle of Hope Dr Salt Lake City UT 84112-5550 |
| Phone Number | 8015876336 |
| Gender | M |
| Graduation Year | 2016 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 0941525273 |
| Number of Group Practice Members | 1143 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 460009 | UNIVERSITY OF UTAH HOSPITALS AND CLINICS |
| Address | Phone | Organization |
|---|---|---|
| 2000 Circle of Hope Dr, Salt Lake City, UT 84112-5550 | 8015876336 | UNIVERSITY OF UTAH ADULT SERVICES |
| 50 N Medical Dr, Salt Lake City, UT 84132-0100 | UNIVERSITY OF UTAH ADULT SERVICES | |
| 65 S Mario Capecchi Dr, Salt Lake City, UT 84132-0005 | 8015812352 | UNIVERSITY OF UTAH ADULT SERVICES |
| Organization Legal Name | UNIVERSITY OF UTAH ADULT SERVICES |
| Physicians | 1332 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ann E Lawrence | Anesthesiology | University of Utah Adult Services | 1950 Circle of Hope Dr, Salt Lake City, UT 84112-5500 |
| Genevieve Noelle Olivier | Physical Therapy | University of Utah Adult Services | 30 N, Suite 444, Salt Lake City, UT 84132-0002 |
| John Evan Thomas | Physician Assistant | University of Utah Adult Services | 165 N University Ave, Farmington Health Center Dermatol, Farmington, UT 84025-2990 |
| Douglas P Marx | Ophthalmology | University of Utah Adult Services | 65 S Mario Capecchi Dr, Salt Lake City, UT 84132-0005 |
| Mary D Foye | Qualified Speech Language Pathologist | University of Utah Adult Services | 417 S Wakara Way, Suite 1112, Salt Lake City, UT 84108-1448 |
| Ligia V Onofrei | Neurology | University of Utah Adult Services | 175 N Medical Dr, Salt Lake City, UT 84132-5901 |
| Naomi R Laird | Physician Assistant | University of Utah Adult Services | 590 S Wakara Way, Salt Lake City, UT 84108-1200 |
| Douglas J Ballard | Physical Therapy | University of Utah Adult Services | 520 S Wakara Way, Suite 302, Salt Lake City, UT 84108-1213 |
| Jonathan R Roddy | Emergency Medicine | University of Utah Adult Services | 1200 College Dr, Rock Springs, WY 82901-5868 |
| Carina Jackman | Anesthesiology | University of Utah Adult Services | 50 N Medical Dr, Salt Lake City, UT 84132-0100 |
| Street Address |
2000 CIRCLE OF HOPE DR |
| City | SALT LAKE CITY |
| State | UT |
| Zip | 84112-5550 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joel Wenger | Physician Assistant | University of Utah Adult Services | 2000 Circle of Hope Dr, Salt Lake City, UT 84112-5550 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melinda Charlet | Registered Dietitian Or Nutrition Professional | Dialysis Program Physicians University of Utah | 85 Medical Dr, Salt Lake City, UT 84112-1100 |
| Wei Ting Chao | Physician Assistant | University of Utah Community Physicians Group | 555 Foothill Dr, Salt Lake City, UT 84112-1106 |
| Susan D Pohl | Family Medicine | University of Utah Community Physicians Group | 555 Foothill Dr, Salt Lake City, UT 84112-1106 |
| Michael Incze | Internal Medicine | University of Utah Adult Services | 555 Foothill Dr, Salt Lake City, UT 84112-1106 |
| Kristin Hueftle | Geriatric Medicine | University of Utah Adult Services | 555 Foothill Dr, Salt Lake City, UT 84112-1106 |
| Wagma Mohmand | Physician Assistant | University of Utah Community Physicians Group | 555 Foothill Dr, Salt Lake City, UT 84112-1106 |
| Julie O King | Certified Nurse Midwife (cnm) | University of Utah Adult Services | 555 Foothill Dr, Salt Lake City, UT 84112-1106 |
| Sara Samtoma Kaplan | Physician Assistant | University of Utah Community Physicians Group | 555 Foothill Dr, Salt Lake City, UT 84112-1106 |
| Carey A Wilson | Pediatric Medicine | University of Utah Pediatric Services | 555 Foothill Dr, Salt Lake City, UT 84112-1106 |
| Matthew James Mulligan | Internal Medicine | University of Utah Adult Services | 555 Foothill Dr, Salt Lake City, UT 84112-1106 |
| Find all physicians in zip 84112 | |||
| City | SALT LAKE CITY |
| Zip Code | 84112 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | SALT LAKE CITY + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.