UNIVERSITY OF UTAH ADULT SERVICES (NPI# 1407250202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407250202 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF UTAH ADULT SERVICES |
| Other Organization Name | UNIVERSITY OF UTAH HOSPITAL HUMAN DEVELOPMENT DIVISION |
| Practice Address |
50 N Medical Dr Salt Lake City UT 84132-0001 |
| Mailing Address |
Po Box 841450 Los Angeles CA 90084-1450 |
| Practice Telephone | 8015812121 |
| Mailing Telephone | 8015876336 |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2020-05-20 |
| Authorized Official Name | EDWARD CLARK (DEPT. CHAIR) |
| Authorized Official Telephone | 8015876336 |
| Is Organization Subpart | Y |
| Parent Organization Name | UNIVERSITY OF UTAH ADULT SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| University of Utah Hospital Human Development Division | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982135984 | University of Utah Adult Services | Audiologist | 417 S Wakara Way, 1112, Salt Lake City, UT 84108-1436 | 2017-03-22 |
| 1083158257 | University of Utah Adult Services | Dentist | 375 S Chipeta Way Ste A200, Salt Lake City, UT 84108-1261 | 2016-12-07 |
| 1649724139 | University of Utah Adult Services | Dermatology | 165 N. University Ave. Farmington, Farmington, UT 84025 | 2016-08-12 |
| 1255719407 | University of Utah Adult Services | Internal Medicine | 1208 Hilltop Dr Ste 102, Rock Springs, WY 82901-5858 | 2015-05-08 |
| 1932586294 | University of Utah Adult Services | Internal Medicine | 250 South Eagle Road, Meridian, ID 83642 | 2015-05-06 |
| 1629455282 | University of Utah Adult Services | Internal Medicine | 976 Mountian City Hwy, A Plus Total Care, Elko, NV 89801-2728 | 2015-05-04 |
| 1356745137 | University of Utah Adult Services | Internal Medicine | 1950 E Circle of Hope Drive, Salt Lake City, UT 84112 | 2014-10-22 |
| 1851904247 | University of Utah Adult Services | Orthopaedic Surgery | 9385 S Snowbird Center Dr, Sandy, UT 84092-6249 | 2020-08-26 |
| 1114431921 | University of Utah Adult Services | Internal Medicine | 1950 Circle of Hope Dr, Salt Lake City, UT 84112-5500 | 2017-12-01 |
| 1174033989 | University of Utah Adult Services | Clinic/Center | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2017-10-06 |
| Street Address |
50 N MEDICAL DR |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84132-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477555696 | Yaw Ababio Boateng | Internal Medicine | 50 N Medical Dr, Salt Lake City, UT 84132-0100 | 2005-06-01 |
| 1073114864 | Stephanie Bevill | Registered Nurse | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-11-06 |
| 1609477801 | Justin Larson | Physical Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-11-04 |
| 1366042467 | Kirsty Aleah Vannoy | Occupational Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-10-28 |
| 1629675673 | Erica Kueneman | Nurse Practitioner | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-10-02 |
| 1487266680 | Michelle A Barker | Physical Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-08-19 |
| 1770195943 | Lisa M Schaeffer | Nurse Practitioner | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-08-19 |
| 1194336289 | Michelle Rios | Physical Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-08-12 |
| 1932710027 | Tanner Ladsten | Physical Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-08-12 |
| 1578174660 | Rachel Sette | Occupational Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-08-12 |
| Find all providers in the same location | ||||
| 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 | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083638308 | Mark Andrew Supiano | Internal Medicine | University of Utah Healthcare, 30 North 1900 East; Ab193 Som, Salt Lake City, UT 84132-0001 | 2006-07-27 |
| 1568489375 | Rachael Stubbs | Internal Medicine | 2981 Juliet Way, Salt Lake City, UT 84121-7023 | 2006-07-16 |
| 1265475131 | Byron Bair | Internal Medicine | Slc Vamc Grecc (182), 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2006-06-14 |
| 1457398703 | Randall W. Rupper | Internal Medicine | Grecc (182) Bldg. 2, Vamc, 500 Foothill Drive, Salt Lake City, UT 84148-0001 | 2006-06-02 |
| 1609263300 | Shannon M. Devlin | Internal Medicine | 30 N 1900 E Rm 4c104, Salt Lake City, UT 84132-0002 | 2015-04-20 |
| 1164765053 | Kristin Marie Hueftle | Internal Medicine | 555 Foothill Dr, Salt Lake City, UT 84112-1106 | 2013-03-29 |
| 1689709859 | Ihc Health Services Inc | Internal Medicine | 324 10th Ave, #200, Salt Lake City, UT 84103-2853 | 2007-02-21 |
| 1629145123 | Laurene Gay Joseph | Internal Medicine | 1160 E 3900 S, G200, Salt Lake City, UT 84124-1202 | 2006-11-29 |
| 1609966217 | Jonathan Rich Nebeker | Internal Medicine | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2006-10-13 |
| 1487744553 | Danesh Rahimi | Internal Medicine | 1160 E 3900 S, G200, Salt Lake City, UT 84124-1202 | 2006-10-12 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84132 |
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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.