TRAVIS SCOTT WALL (NPI# 1518048305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518048305 |
| Entity Type | Individual |
| Full Name | TRAVIS SCOTT WALL |
| Credential | MD |
| Practice Address |
50 N Medical Dr Salt Lake City UT 84132-0001 |
| Mailing Address |
Po Box 413033 Salt Lake City UT 84141-3033 |
| Practice Telephone | 8015853229 |
| Mailing Telephone | 8012133900 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2013-11-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
3105478-1205 | UT | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326518960 | Travis Wall | Pharmacist | 933 E Mission Ave, Spokane, WA 99202 | 2018-11-27 |
| 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 | 207RC0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Clinical Cardiac Electrophysiology |
| A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them. |
| 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 |
|---|---|---|---|---|
| 1851795652 | University of Utah Adult Services | Internal Medicine | 50 North Medical Drive, Salt Lake City, UT 84132 | 2014-10-22 |
| 1164842415 | Karnika Ayinapudi | Internal Medicine | 30 N 1900 E Rm 4a100, Salt Lake City, UT 84132-0002 | 2014-04-24 |
| 1992967335 | Nischala Nannapaneni | Internal Medicine | 1160 E 3900 S Ste 2000, Salt Lake City, UT 84124-1236 | 2008-06-26 |
| 1952480527 | Susan P. Etheridge | Internal Medicine | 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 | 2006-11-03 |
| 1790866580 | Roger A. Freedman | Internal Medicine | 100 N Medical Dr, Salt Lake City, UT 84113-1103 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497078786 | Seongwook Han | Internal Medicine | 1055 N 500 W, Ste 101, Provo, UT 84604-3305 | 2010-03-01 |
| 1952569931 | Yonathan Melman | Internal Medicine | 4403 Harrison Blvd, Ste 3450, Ogden, UT 84403-3271 | 2008-05-27 |
| 1417025628 | Michael Cutler | Internal Medicine | 5169 S Cottonwood St, Ste 510, Murray, UT 84107-6767 | 2006-12-04 |
| 1366413924 | John H. Jentzer | Internal Medicine | 1380 E Medical Center Dr, Suite 1500, St George, UT 84790-2123 | 2006-01-31 |
| 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.