UNIVERSITY OF UTAH OTOLARYNGOLOGY PEDIATRICS


Address: 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103
Phone: 8015882000

UNIVERSITY OF UTAH OTOLARYNGOLOGY PEDIATRICS (NPI# 1508875857) 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) 1508875857
Entity Type Organization
Organization Name UNIVERSITY OF UTAH OTOLARYNGOLOGY PEDIATRICS
Practice Address 100 Mario Capecchi Dr
Salt Lake City
UT 84113-1103
Mailing Address Po Box 413035
Salt Lake City
UT 84141-0001
Practice Telephone 8015882000
Mailing Telephone 8012133800
Enumeration Date 2006-08-05
Last Update Date 2009-04-14
Authorized Official Name JANELL I MADONNA (DIRECTOR OF CONTRACTING AND PE)
Authorized Official Telephone 8015876464
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207YP0228X Otolaryngology
Specialization: Pediatric Otolaryngology
Allopathic & Osteopathic Physicians
N 231H00000X Audiologist Speech, Language and Hearing Service Providers
N 231HA2400X Audiologist
Specialization: Assistive Technology Practitioner
Speech, Language and Hearing Service Providers
Y 207Y00000X Otolaryngology Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NM 57507325 05
CO 45200289 05
ID 805957800 05
UT RAILROAD MEDICARE CJ3240 01

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
Find all providers in the same location

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 207Y00000X
Grouping Allopathic & Osteopathic Physicians
Classification Otolaryngology

Taxonomy Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1073177796 Christopher A. Hamilton Otolaryngology 50 North Medical Dr Som 3c120, Salt Lake City, UT 84132-0001 2019-04-29
1972007433 Eric Edward Babajanian Otolaryngology 50 N Medical Dr Som 3c120, Salt Lake City, UT 84132-0001 2018-03-20
1447551544 James L. Parkin Otolaryngology 2390 Bernadine Dr, Salt Lake City, UT 84109-1206 2010-11-05
1700023900 Dean Harding Zobell Otolaryngology 1530 Chandler Dr, Salt Lake City, UT 84103-4219 2009-01-10
1881839041 Lisa M. Morris Otolaryngology 5089 S. 900 E., Suite 100, Salt Lake City, UT 84117-5731 2008-12-02
1528181955 James Barry Nielsen Otolaryngology 128 S 1000 E, Salt Lake City, UT 84102-1403 2007-04-09
1649396185 Preston Daniel Ward Otolaryngology 6322 S 3000 E Ste 170, Salt Lake City, UT 84121-7290 2007-03-22
1134280928 G Marsden Blanch Otolaryngology 3195 S Main St # 200, Salt Lake City, UT 84115-3749 2006-12-13
1942313796 Steven K Miller Otolaryngology 22 S 900 E, Salt Lake City, UT 84102-1307 2006-08-16
1053347765 Russell Jon Ord Otolaryngology 333 S 900 E, Salt Lake City, UT 84102-2310 2006-06-24
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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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