SLC VA MEDICAL CENTER (NPI# 1023306297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023306297 |
| Entity Type | Organization |
| Organization Name | SLC VA MEDICAL CENTER |
| Practice Address |
500 Foothill Drive Salt Lake City UT 84148 |
| Mailing Address |
500 Foothill Dr Salt Lake City UT 84148-0001 |
| Practice Telephone | 8015821565 |
| Mailing Telephone | 8015821565 |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2011-07-21 |
| Authorized Official Name | TRACY W DUSTIN (CASE MANAGER) |
| Authorized Official Telephone | 8015821565 |
| Authorized Official Credential | RN, MSN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 284300000X | Special Hospital | 184759-3102 | UT | Hospitals |
| Street Address |
500 FOOTHILL DRIVE |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770530800 | Gerald Saul Treiman | Surgery | 500 Foothill Drive, Salt Lake City, UT 84103 | 2006-05-27 |
| 1477107944 | Rachael Patterson | Student in an Organized Health Care Education/Training Program | 500 Foothill Drive, Salt Lake City, UT 84148 | 2019-08-01 |
| 1609433572 | Jennylynn F Palisoc | Nurse Practitioner | 500 Foothill Drive, Salt Lake City, UT 84148 | 2019-05-24 |
| 1609224047 | Edward Eugene Wirkowski | Nurse Practitioner | 500 Foothill Drive, Building 3 - Ipu, Salt Lake City, UT 84148 | 2016-05-26 |
| 1831409960 | Rose Mary Jepson-sullivan | Dietitian, Registered | 500 Foothill Drive, George E. Wahlen Dept of Va Medical Ctr, Salt Lake City, UT 84148-0001 | 2010-10-07 |
| 1467781526 | Sharon Mcwilliams Laurenzi | Registered Nurse | 500 Foothill Drive, George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT 84148 | 2009-12-18 |
| 1740386085 | Lucy Hall Leaver | Nurse Practitioner | 500 Foothill Drive, Salt Lake Va Hospital, Salt Lake City, UT 84148 | 2006-09-15 |
| 1922017888 | David Causey | Internal Medicine | 500 Foothill Drive, Salt Lake City, UT 84148-0001 | 2006-08-07 |
| 1780627455 | Patrick Joseph Miller | Psychologist | 500 Foothill Drive, Va Salt Lake City Health Care System, Salt Lake City, UT 84148 | 2006-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598211799 | Jacquelyn Rae Contant | Dietitian, Registered | 500 Foothill Dr. (120), Salt Lake City, UT 84148 | 2016-08-28 |
| 1699127811 | Taylor Alford | Pharmacist | 500 Foothills Drive, Salt Lake City, UT 84148 | 2016-07-12 |
| 1356792162 | Sarah Hummel | Genetic Counselor, MS | 500 Foothill Drive, Sarah Hummel, Va Salt Lake City, Genomic Medicine (10p4e), Salt Lake City - Salt Lake, UT 84148 | 2016-06-23 |
| 1174936140 | Elizabeth Shade Cardenas | Nurse Practitioner | 500 Foothill Drive #182h, Veterans Healthcare Administration, Salt Lake City, UT 84148 | 2014-06-08 |
| 1386904043 | David Earl Moore | Specialist | 500 Foothill Blvd (research), George E. Wahlen Va Healthcare System, Salt Lake City, UT 84148 | 2012-05-29 |
| 1790059038 | Deborah Ernstein Holley Hartzfeld | Genetic Counselor, MS | 615 Arapeen Drive #212, Salt Lake City, UT 84148 | 2012-03-05 |
| 1073823720 | Diana Lynn Robbins | Social Worker | 9140 W. Post Road, Las Vegas, NV 84148 | 2010-10-15 |
| 1659534394 | Katherine Margaret Dunn | Genetic Counselor, MS | 500 Foothill Drive (151z), Salt Lake City, UT 84148 | 2008-07-02 |
| 1730381625 | Douglas James Ball | Medical Genetics | Va Salt Lake City Health Care System 10p11, Salt Lake City, UT 84148 | 2007-06-03 |
| 1245339530 | Daniel H Priestly | Radiology | 500 Foothill Dr., Salt Lake City, UT 84148 | 2006-09-22 |
| Find all providers in zip 84148 | ||||
| Taxonomy Code | 284300000X |
| Grouping | Hospitals |
| Classification | Special Hospital |
| A designation by the AHA of a hospital whose primary function of the institution is to provide diagnostic and treatment services for patients who have specified medical conditions, both surgical and nonsurgical. |
| Notes: Source: AHA Guide, Registration section, p. A5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124208343 | Gateway Aestheetic Institute& Laser Center | Special Hospital | 440 W 200 S Ste 250, Salt Lake City, UT 84101-1462 | 2007-11-05 |
| 1649470113 | New Life Centers | Special Hospital | 1255 E 3900 S Ste 300, Salt Lake City, UT 84124-1389 | 2007-07-23 |
| 1801181631 | University of Utah | Special Hospital | 175 N Medical Dr, Salt Lake City, UT 84132-0001 | 2011-06-09 |
| 1104075092 | Victoria Serpico | Special Hospital | 1950 Circle of Hope, Suite Number 6500, Salt Lake City, UT 84112 | 2008-09-16 |
| 1598801300 | Mary Lampas | Special Hospital | 1950 Circle of Hope Dr, Suite 2110, Salt Lake City, UT 84112-5500 | 2007-01-29 |
| 1538271861 | Christopher Burr Dechet | Special Hospital | 1950 Circle of Hope Dr, Rm 6755, Salt Lake City, UT 84112-5500 | 2006-08-31 |
| 1568494060 | Va Health Care System, Salt Lake City, Ut | Special Hospital | 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093189839 | St. George Detox Center LLC | Special Hospital | 120 W 1470 S Bldg B, St George, UT 84770-6798 | 2015-11-17 |
| 1831505874 | Shadow Mountain LLC. | Special Hospital | 120 W. 1470 South, Building B, St. George, UT 84770 | 2014-07-10 |
| 1063754893 | Trenton Lyle Neal | Special Hospital | 308 W 7200 S, Midvale, UT 84047-1041 | 2013-03-19 |
| 1629411020 | Valerie Price | Special Hospital | 9414 S 1335 E, Sandy, UT 84092-2947 | 2013-04-16 |
| 1780926592 | Deborah Deann Rowley | Special Hospital | 308 W 7200 S, Midvale, UT 84047-1041 | 2013-03-19 |
| 1215294228 | Hyrum John Kerbs | Special Hospital | 5848 Fashion Blvd, Murray, UT 84107-6121 | 2012-04-13 |
| 1609886126 | Ihc Health Services Inc. | Special Hospital | 5848 Fashion Blvd, Murray, UT 84107-6121 | 2006-08-08 |
| City | SALT LAKE CITY |
| Zip Code | 84148 |
Please comment or provide details below to improve the information on SLC VA 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.