DANA BOUCEK


Address: 100 North Mario Capecchi Dr., Primary Children's, Salt Lake City, UT 84113
Phone: 8016625700

DANA BOUCEK (NPI# 1154612117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1154612117
Entity Type Individual
Full Name DANA BOUCEK
Practice Address 100 North Mario Capecchi Dr.
Primary Children's
Salt Lake City
UT 84113
Mailing Address 3601 Market St Unit 1713
Philadelphia
PA 19104-5914
Practice Telephone 8016625700
Mailing Telephone (303) 746-7692
Enumeration Date 2011-04-26
Last Update Date 2018-03-17
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080P0202X Pediatrics
Specialization: Pediatric Cardiology
MD460722 PA Allopathic & Osteopathic Physicians
N 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Provider Secondary Practice Location

Address Telephone Number Fax Number
3401 Civic Center Blvd, Division of Pediatric Cardiology, Phildelphia, PA 19104 2155903274

Office Location

Street Address 100 NORTH MARIO CAPECCHI DR.
PRIMARY CHILDREN'S
City SALT LAKE CITY
State UT
Zip Code 84113

Providers in the same zip code

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
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
1083864763 Patricia Ann Jones Nurse Practitioner 100 No. Medical Drive, Attn Same Day Surgery, Salt Lake City, UT 84113 2008-09-30
Find all providers in zip 84113

Taxonomy Information

Taxonomy Code 2080P0202X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Pediatric Cardiology

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1053845339 Matthew David Beaver Pediatrics 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2017-04-13
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

Competitor

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City SALT LAKE CITY
Zip Code 84113

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Dataset Information

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.

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