SHANNON MICHELLE SUNDBERG


Address: 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103
Phone: 8012771207

SHANNON MICHELLE SUNDBERG (NPI# 1154670503) 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) 1154670503
Entity Type Individual
Full Name SHANNON MICHELLE SUNDBERG
Credential MS, RD, CD
Practice Address 100 Mario Capecchi Dr
Salt Lake City
UT 84113-1103
Practice Telephone 8012771207
Mailing Telephone 8012771207
Enumeration Date 2012-08-30
Last Update Date 2012-08-30
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 133VN1004X Dietitian, Registered
Specialization: Nutrition, Pediatric
3781234901 UT Dietary & Nutritional Service Providers

Office Location

Street Address 100 MARIO CAPECCHI DR
City SALT LAKE CITY
State UT
Zip Code 84113-1103

Providers in the same location

NPI Name Taxonomy Address Enumeration
1033111810 Andrew Gerald Smith Legal Medicine 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2005-08-11
1235535485 Ihc Health Services Inc Clinic/Center 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2014-11-17
1508262833 Aimee Brierley Occupational Therapist 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2014-11-13
1801290986 Jeffery Zobell Pharmacist 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2014-10-17
1336542778 Bevan Jensen Pharmacist 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2014-09-30
1699183152 Kristina Rogers Dentist 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2014-07-29
1548677297 Stephanie Eva Wisniewski Speech-Language Pathologist 100 Mario Capecchi Dr, Primary Children's Rehab, Salt Lake City, UT 84113-1103 2014-07-15
1184044877 Adam Wesley Dell Pediatrics 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2014-04-21
1225456718 Bhanu Muniyappa Pediatrics 100 Mario Capecchi Dr, Pediatrics Residency Program, Salt Lake City, UT 84113-1103 2014-04-01
1265850952 Kristina Gulliver Pediatrics 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2014-03-31
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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
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
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Taxonomy Information

Taxonomy Code 133VN1004X
Grouping Dietary & Nutritional Service Providers
Classification Dietitian, Registered
Specialization Nutrition, Pediatric

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1174996151 Susan Reese Dietitian, Registered 2147 E Pinnacle Terrace Way, Apt 103, Salt Lake City, UT 84121-5062 2015-11-12
1063021699 Sara Stevenson Dietitian, Registered 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-07-29
1306475124 Nicole Williams Dietitian, Registered 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 2020-04-03
1487165908 Jessica Brothers Clayton Dietitian, Registered 50 N Medical Dr, Salt Lake City, UT 84132-0001 2017-10-24
1649717562 Madeline Gochnour Dietitian, Registered 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2017-01-30
1528421435 Moira Flannery Kryger Dietitian, Registered 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2016-03-30
1447610936 Cynthia Panish Dietitian, Registered 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2016-02-26
1801146279 Kristen Strong Dietitian, Registered 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2012-09-13
1083964514 Janet Gardner Bowman Dietitian, Registered 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2012-09-12
1164771572 Catherine M. Mcdonald Dietitian, Registered 100 Mario Capecchi Dr, Dietitians' Office, 2nd Floor, Salt Lake City, UT 84113-1103 2012-08-30
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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