PARK TERRACE ANESTHESIA ASSOCIATES LLC (NPI# 1245843325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245843325 |
| Entity Type | Organization |
| Organization Name | PARK TERRACE ANESTHESIA ASSOCIATES LLC |
| Practice Address |
650 E 4500 S Ste 100 Salt Lake City UT 84107-4536 |
| Practice Telephone | 8012612000 |
| Practice Fax Number | 8012614539 |
| Mailing Telephone | 8012612000 |
| Mailing Fax Number | 8012614539 |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2020-08-28 |
| Authorized Official Name | THOMAS WARDLE (CEO) |
| Authorized Official Telephone | 8012612000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Street Address |
650 E 4500 S STE 100 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84107-4536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053924209 | Park Terrace Surgical Associates LLC | Clinic/Center | 650 E 4500 S Ste 100, Salt Lake City, UT 84107-4536 | 2020-08-27 |
| 1215540968 | Park Terrace Surgical Center LLC | Clinic/Center | 650 E 4500 S Ste 100, Salt Lake City, UT 84107-4536 | 2020-08-24 |
| 1326660374 | Jbr Surgical Center, LLC | Clinic/Center | 650 E 4500 S Ste 100, Salt Lake City, UT 84107-4536 | 2020-05-13 |
| 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 |
| Find all providers in zip 84107 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639704208 | Salt Lake Surgery Center, LLC | Clinic/Center | 1046 E 100 S Ste D, Salt Lake City, UT 84102-1520 | 2020-03-04 |
| 1952720674 | Bountiful Surgery Center, LLC | Clinic/Center | 6360 S 3000 E Ste 320, Salt Lake City, UT 84121-6932 | 2014-04-09 |
| 1932407277 | Stephen H Bennett Md PC | Clinic/Center | 1045 E 3900 S Ste 201, Salt Lake City, UT 84124-1192 | 2011-03-10 |
| 1568644771 | Physicians Service Group, Inc. | Clinic/Center | 7369 East 2223 South, Salt Lake City, UT 84109 | 2007-11-29 |
| 1780885442 | Lyssa Inc | Clinic/Center | 530 E 500 S, Salt Lake City, UT 84102-2746 | 2007-05-30 |
| 1790906204 | Ear, Nose & Throat Surgery Center of Utah LLC | Clinic/Center | 22 S 900 E Ste 2, Salt Lake City, UT 84102-1307 | 2007-05-01 |
| 1164647707 | Ihc Health Services, Inc. | Clinic/Center | 359 8th Ave, Salt Lake City, UT 84103-2895 | 2007-04-17 |
| 1922148063 | The Surgery Center At Salt Lake Regional, L.L.C. | Clinic/Center | 82 South 1100 East, Suite 200, Salt Lake City, UT 84102 | 2007-02-07 |
| 1881701290 | Wasatch Endoscopy Center Ltd | Clinic/Center | 1220 E 3900 S Ste 1b, Salt Lake City, UT 84124-1327 | 2006-08-23 |
| 1609896216 | Salt Lake Endoscopy Center | Clinic/Center | 24 S 1100 E Ste 103, Salt Lake City, UT 84102-1592 | 2006-07-20 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84107 |
Please comment or provide details below to improve the information on PARK TERRACE ANESTHESIA ASSOCIATES LLC.
| 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.