DAVID CROCKETT (NPI# 1104351592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104351592 |
| Entity Type | Individual |
| Full Name | DAVID CROCKETT |
| Practice Address |
University of Utah School of Medicine 30 N 1900 E 1c026 Salt Lake City UT 84132-2147 |
| Mailing Address |
975 E 3rd St Att: Velvet Green, Program Coordinator Em Residency Chattanooga TN 37403-2147 |
| Practice Telephone | 8015812417 |
| Mailing Telephone | 4237787673 |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2020-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 11680436-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 59020 | TN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 975 E 3rd St, Att: Velvet Green, Program Coordinator Em Residency, Chattanooga, TN 374032147 | 4237787673 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215306485 | David Crockett | Acupuncturist | 78 Haele Pl, Makawao, HI 96768-8054 | 2015-09-17 |
| 1801107636 | David G Crockett | Internal Medicine | 985100 Nebraska Medical Ctr, Omaha, NE 68198-5100 | 2010-06-26 |
| 1629234620 | David Hubert Larue Crockett | Counselor | 2201 N. 22nd Ave., Suite Number A, Show Low, AZ 85901-1587 | 2008-07-30 |
| 1871003905 | David E Crockett | Counselor | 627 Ne Evans St, Mcminnville, OR 97128-3923 | 2017-10-03 |
| 1730315342 | David Bowen Crockett | Massage Therapist | 1245 Charnelton St, Suite 8, Eugene, OR 97401-6214 | 2009-06-09 |
| 1225282882 | David J. Crockett | Otolaryngology | 4545 E Chandler Blvd, Suite 202, Phoenix, AZ 85048-7645 | 2008-11-10 |
| 1376605535 | David Shan Crockett | Psychiatry & Neurology | 911 Sunset Dr, Hollister, CA 95023-5602 | 2006-12-14 |
| 1356367502 | David Sanders Crockett | Dentist | 22296 Main St, Hayward, CA 94541 | 2006-07-14 |
| 1891779690 | David Kim Crockett | Optometrist | 1345 Wadsworth Blvd, Lakewood, CO 80214-4209 | 2005-12-05 |
| Street Address |
UNIVERSITY OF UTAH SCHOOL OF MEDICINE 30 N 1900 E 1C026 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84132-2147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275162331 | Scott Andrew Rizzi | Student in an Organized Health Care Education/Training Program | 30 North 1900 East Som 4c116, Salt Lake City, UT 84132 | 2020-04-02 |
| 1609421403 | Monika Fleckenstein | Ophthalmology | 65 Mario Capecchi Drive, John A. Moran Eye Center, Salt Lake City, UT 84132 | 2019-08-08 |
| 1366975914 | Jacob Brandenburg | Anesthesiology | School of Medicine 30 North 1900 East Room 3c444, Salt Lake City, UT 84132 | 2017-04-10 |
| 1568815082 | Anastasia Neufeld | Ophthalmology | 65 Mario Capecchi Drive, Salt Lake City, UT 84132 | 2016-07-20 |
| 1912350083 | Gmaan Alzhrani | Student in an Organized Health Care Education/Training Program | 175 N. Medical Drive East , Salt Lake City, UT 84132 | 2016-07-13 |
| 1831544600 | Drew Goerke | Occupational Therapist | 50 N Medical Drive, Som Room #1r73, Salt Lake City, UT 84132 | 2016-04-29 |
| 1891179024 | Bong Jik Kim | Student in an Organized Health Care Education/Training Program | 50 North Medical Drive 3c120, Otolaryngology Administration Office, Salt Lake City, UT 84132 | 2015-07-17 |
| 1043699101 | Chris Anderson | Physician Assistant | 30 North 1900 East #3c344, Salt Lake City, UT 84132 | 2015-05-22 |
| 1689061822 | Ryan Clark | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 30 N 1900 E Som 3c127, Salt Lake City, UT 84132 | 2015-04-24 |
| 1649666264 | Kevin Conrad | Anesthesiology | 30 N 1900 E Room 3c444, Salt Lake City, UT 84132 | 2015-04-09 |
| Find all providers in zip 84132 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700414216 | True North Health Navigation LLC | Emergency Medicine | 136 E South Temple Ste 1400, Salt Lake City, UT 84111-1143 | 2020-03-30 |
| 1609377589 | David A. Burton | Emergency Medicine | 1040 S Oak Hills Way, Salt Lake City, UT 84108-2024 | 2018-02-26 |
| 1184131922 | Wally Lee | Emergency Medicine | 3539 E Brighton Point Dr, Salt Lake City, UT 84121-5510 | 2018-01-02 |
| 1295240026 | Allison Mcphee | Emergency Medicine | 1021 E 3300 S, Salt Lake City, UT 84106-2142 | 2017-12-01 |
| 1699160598 | Sean Damian Slack | Emergency Medicine | Division of Emergency Medicine School Of, 30 N 1900 E 1c026, Salt Lake City, UT 84132-0001 | 2015-03-30 |
| 1801201496 | Dwight Burdick | Emergency Medicine | 2665 E 2100 S, Salt Lake City, UT 84109-1372 | 2014-06-23 |
| 1467872358 | Anna Rudolphi | Emergency Medicine | 30 N 1900 E 1c026, Division of Emergency Medicine- University of Utah, Salt Lake City, UT 84132 | 2014-04-18 |
| 1598004087 | Alison L Smith | Emergency Medicine | 764 E Hawthorne Ave, Salt Lake City, UT 84102 | 2013-02-04 |
| 1205195229 | Brian Galovic | Emergency Medicine | University of Utah Hospital Emergency, 50 North Medical Drive, Salt Lake City, UT 84132-0001 | 2012-05-11 |
| 1598031858 | Brandon Mark Flammer | Emergency Medicine | 144 S 500 E Fl 2, Salt Lake City, UT 84102-1907 | 2012-03-30 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84132 |
Please comment or provide details below to improve the information on DAVID CROCKETT.
| 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.