CARL EDWARD WYNE (NPI# 1114947223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114947223 |
Entity Type | Individual |
Full Name | CARL EDWARD WYNE |
Credential | MD |
Practice Address |
5770 Fashion Blvd Murray UT 84107-6548 |
Mailing Address |
Po Box 27128 Salt Lake City UT 84127-0128 |
Practice Telephone | 8013144544 |
Mailing Telephone | 8013144544 |
Enumeration Date | 2006-07-20 |
Last Update Date | 2007-10-18 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
3114301205 | UT | Allopathic & Osteopathic Physicians |
Street Address |
5770 FASHION BLVD |
City | MURRAY |
State | UT |
Zip Code | 84107-6548 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255304408 | Lisa Doyle | Emergency Medicine | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-02-08 |
1881870152 | John G. Robinson, M.d., P.C. | Specialist | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2008-01-16 |
1194929083 | Amy Lyn Hansen | Speech-Language Pathologist | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2007-06-13 |
1245452515 | Scott James Jolley | Emergency Medicine | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2007-05-03 |
1700919354 | Amy Lynne Leiseth | Physical Therapist | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2007-03-13 |
1083715445 | John G Robinson | Specialist | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-09-26 |
1285737445 | Edward A Loeser | Anesthesiology | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-09-06 |
1316049588 | Gaylon K Peterson | Anesthesiology | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-09-01 |
1174635494 | Brenda K Blackham | Anesthesiology | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-08-31 |
1669585600 | Pardis A Brown | Speech-Language Pathologist | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-08-16 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
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Taxonomy Code | 207QG0300X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Specialization | Geriatric Medicine |
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
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1083998603 | Ogden Internal Medicine and Urology | Family Medicine | 2950 N Church Street, Layton, UT 84040 | 2011-09-30 |
1447226717 | John R Dietlein | Family Medicine | 6886 Hollow Mill Dr, Salt Lake City, UT 84121-3322 | 2006-02-27 |
1508145111 | Ihc Health Services Inc | Family Medicine | 9720 S 1300 E, Ste E240, Sandy, UT 84094-3795 | 2011-08-12 |
1235426925 | Steven E Warren Md PC LLC | Family Medicine | 4790 Hidden Lake Dr, Bountiful, UT 84010-6083 | 2011-07-01 |
1396999868 | Cynthia Jean Lawlor | Family Medicine | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2008-11-11 |
1760650527 | Columbia Ogden Regional | Family Medicine | 5405 S 500 E, Suite 110, Ogden, UT 84405-6957 | 2008-02-14 |
1689746786 | Nancy Jo Zega | Family Medicine | 425 E 5350 S, 255, Ogden, UT 84405-6946 | 2006-11-14 |
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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.