SAMUEL HARRY VAN RENSBURG (NPI# 1063067346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063067346 |
| Entity Type | Individual |
| Full Name | SAMUEL HARRY VAN RENSBURG |
| Credential | NP-C |
| Practice Address |
440 S 500 E Salt Lake City UT 84102-2705 |
| Mailing Address |
1841 E Ramona Ave Salt Lake City UT 84108-3111 |
| Practice Telephone | 2033439490 |
| Mailing Telephone | 2033439490 |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2020-09-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
11839389-4409 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
APRN02110 | RI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
11839389-4409 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
APRN02110 | RI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
APRN02110 | RI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
440 S 500 E |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84102-2705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912205824 | Jessica B. Jeffs | Counselor | 440 S 500 E, Salt Lake City, UT 84102 | 2011-03-02 |
| 1750998084 | Shasta Galyon | Peer Specialist | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-09-30 |
| 1538772280 | Theron Ulysses Williams | Case Manager/Care Coordinator | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-08-24 |
| 1316556806 | Sheanna Cronnelly | Case Manager/Care Coordinator | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-07-30 |
| 1700401767 | Jordan Clark Esteban | Social Worker | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-06-15 |
| 1548881097 | Daysha Alayne Clukey | Licensed Practical Nurse | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-05-06 |
| 1780216093 | David Scott Cummins | Social Worker | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-02-05 |
| 1720619893 | John Ritter Pendergrass | Case Manager/Care Coordinator | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-01-28 |
| 1881238608 | Alvilda Olivia Pacheco | Counselor | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2019-11-05 |
| 1881237121 | Elizabeth Crawford | Marriage & Family Therapist | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2019-10-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942818604 | Wendy Vazquez | Behavior Technician | 515 S 700 E Suit 2a, Salt Lake City, UT 84102 | 2020-07-20 |
| 1407481245 | Odyssey House Inc | Family Medicine | 743 E 300 S, Salt Lake City, UT 84102 | 2020-03-11 |
| 1093359960 | Hayle Mayer | Behavior Technician | 515 S 700 E Salt Lake City, Suite 2a, Salt Lake, UT 84102 | 2019-11-04 |
| 1326680869 | Ronald Mcdonald House of The Intermountain Area | Meals | 935 E. South Temple, Salt Lake City, UT 84102 | 2019-10-16 |
| 1508419581 | Claire Pemberton | Behavior Technician | 327 E 1300 S, Apt 2, Salt Lake City, UT 84102 | 2019-07-19 |
| 1558923144 | Olivia Anne Hardwick | Social Worker | Transitions At Slrmc, 86 S. 1100 E. Suite 404, Salt Lake City, UT 84102 | 2019-07-03 |
| 1649741802 | Colten Vancampen | Behavior Technician | 515 S 700 E #2a, Salt Lake City, UT 84102 | 2018-12-16 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1104311661 | Malorey Kooyman | Behavior Technician | 515 700 East, Suite 2a, Salt Lake City, UT 84102 | 2018-06-27 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| Find all providers in zip 84102 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174936140 | Elizabeth Shade Cardenas | Nurse Practitioner | 500 Foothill Drive #182h, Veterans Healthcare Administration, Salt Lake City, UT 84148 | 2014-06-08 |
| 1366737579 | Matrix Medical Network of Utah,llc | Nurse Practitioner | 2150 S 1300 E Ste 500, Salt Lake City, UT 84106-4375 | 2011-06-15 |
| 1265612097 | Solo Clinical Services LLC | Nurse Practitioner | 1864 Downington Ave, Salt Lake City, UT 84108-2912 | 2007-11-09 |
| 1730201245 | William Andrew Schwarz II | Nurse Practitioner | 4701 W 2100 S Bldg 3, C/o Cr England and Lakeside Medical Clinic, Salt Lake City, UT 84120-1223 | 2007-04-04 |
| 1700929338 | Cristine Tuttle | Nurse Practitioner | 375 Chipeta Way Suita A200, University of Utah Hospitals and Clinics, Sleep Center, Salt Lake City, UT 84108-0001 | 2007-02-14 |
| 1972650836 | Valerie Jean Flattes | Nurse Practitioner | Npha 4568 S Highland Drive, #290, Salt Lake City, UT 84117 | 2007-01-04 |
| 1184717878 | Kathleen Hooten | Nurse Practitioner | 555 Foothill Dr Rm 301, Salt Lake City, UT 84112-1106 | 2006-10-02 |
| 1841225372 | Janet E Tulloch | Nurse Practitioner | Va Slc Health Care Sytem 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2006-07-12 |
| 1770556946 | Jane Elizabeth Bell | Nurse Practitioner | George E Whalen Va Med Center (111p), 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2006-02-08 |
| 1639796477 | Lacey A Cooper | Nurse Practitioner | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-06-27 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84102 |
Please comment or provide details below to improve the information on SAMUEL HARRY VAN RENSBURG.
| 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.