DR. MATTHEW DAVID BEAVER (NPI# 1053845339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053845339 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW DAVID BEAVER |
| Credential | MBBS |
| Practice Address |
81 N Mario Capecchi Dr Salt Lake City UT 84113-1125 |
| Practice Telephone | 8012137609 |
| Mailing Telephone | 8012137609 |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2020-06-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
11751221-1205 | UT | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606557 | Matthew James Beaver | Technician | 87 Swierkos Dr, Moundsville, WV 26041-4209 | 2020-10-15 |
| Street Address |
81 N MARIO CAPECCHI DR |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84113-1125 |
| 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 |
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| 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 Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154612117 | Dana Boucek | Pediatrics | 100 North Mario Capecchi Dr., Primary Children's, Salt Lake City, UT 84113 | 2011-04-26 |
| 1447606561 | Bryan Matthew Jepson | Pediatrics | 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 | 2016-05-07 |
| 1902260474 | University of Utah Pediatric Services | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-04-11 |
| 1942664412 | University of Utah Pediatric Services | Pediatrics | 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 | 2016-04-11 |
| 1497118764 | Claire Newlon | Pediatrics | 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 | 2016-04-03 |
| 1811376569 | Rohin Moza | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2015-05-28 |
| 1982095105 | Dwight Robertson | Pediatrics | 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 | 2015-02-10 |
| 1629411970 | Juan Carlos Samayoa | Pediatrics | 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 | 2013-04-16 |
| 1841551140 | Lauren M Andrade | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84132-0002 | 2012-06-04 |
| 1821378704 | Lindsay Jennifer May | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2011-08-23 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84113 |
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| 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.