THERESA ANN HENNESSEY (NPI# 1699826693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699826693 |
| Entity Type | Individual |
| Full Name | THERESA ANN HENNESSEY |
| Credential | M.D. |
| Practice Address |
Shriners Hospitals for Children Fairfax Road At Virginia Street Salt Lake City UT 84103-4399 |
| Mailing Address |
Shriners Hospitals for Children Salt Dept 5034 Los Angeles CA 90084-0001 |
| Practice Telephone | 8015363600 |
| Practice Fax Number | 8015363868 |
| Mailing Telephone | 8132818478 |
| Mailing Fax Number | 8132818113 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2010-09-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XP3100X |
Orthopaedic Surgery Specialization: Pediatric Orthopaedic Surgery |
5897436-1205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | STATE LICENSE | 5897436-1205 | 01 |
| UT | CONTROLLED SUBSTANCE LIC | 5897436-8905 | 01 |
| UT | DEA LICENSE | BH9108273 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023653409 | Theresa M Hennessey | Social Worker | 4502 E Avenue S, Palmdale, CA 93552-4480 | 2019-11-09 |
| Street Address |
SHRINERS HOSPITALS FOR CHILDREN FAIRFAX ROAD AT VIRGINIA STREET |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84103-4399 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932509213 | Paul David Rauch | Specialist/Technologist | 701 De Soto Street, Salt Lake City, UT 84103 | 2014-08-24 |
| 1073866695 | University Neuropsychiatric Institute | Community Based Residential Treatment Facility, Mental Illness | 252 South 500 East, Salt Lake City, UT 84103 | 2012-10-19 |
| 1114285558 | Christopher John Murphy | Student in an Organized Health Care Education/Training Program | 585 1st Ave, Salt Lake City, UT 84103 | 2012-04-23 |
| 1447573266 | Peter Louis Kapelke | Specialist | Fairfax Rd. @ Virginia St., Shriners Hospital Salt Lake City, Salt Lake City, UT 84103 | 2010-03-08 |
| 1578763389 | Susana Auhangamea Kinikini | Nurse Practitioner | Fairfax @ Virginia Street, Salt Lake City, UT 84103 | 2007-07-19 |
| 1609082320 | Cynthia N Shumway | Social Worker | 580 10th Avenue, Salt Lake City, UT 84103 | 2007-05-16 |
| 1811010655 | Kent Walker Farnsworth | Obstetrics & Gynecology | 1509 Federal Heights Drive, Salt Lake City, UT 84103 | 2007-04-09 |
| 1912082421 | Eloise Agnes Maughan | Nurse Practitioner | 324 8th Ave, Lds Hospital, Salt Lake City, UT 84103 | 2006-10-25 |
| 1407968464 | Kit D Smith | Anesthesiology | 359 - 8th Avenue, Asc, Salt Lake City, UT 84103 | 2006-08-31 |
| 1396854113 | Lisa H Carter | Physical Therapist | 1285 East Fairfax Road, Salt Lake City, UT 84103 | 2006-08-29 |
| Find all providers in zip 84103 | ||||
| Taxonomy Code | 207XP3100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Pediatric Orthopaedic Surgery |
| An orthopedic surgeon who has additional training and experience in diagnosing, treating and managing musculoskeletal problems in infants, children and adolescents. These may include limb and spine deformities (such as club foot, scoliosis); gait abnormalities (limping); bone and joint infections; broken bones. |
| Notes: Source: American Academy of Pediatrics, www.aap.org [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528115763 | David L Mccann | Orthopaedic Surgery | 4190 Highland Drive, Suite 102, Salt Lake City, UT 84124-2600 | 2007-01-03 |
| 1689228298 | Meaghan Marien | Orthopaedic Surgery | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2019-07-31 |
| 1750709242 | Abby Mccain Howenstein | Orthopaedic Surgery | 590 S Wakara Way, Salt Lake City, UT 84108-1200 | 2014-04-01 |
| 1396187282 | Shriners Hospitals for Children | Orthopaedic Surgery | 1275 E Fairfax Rd, Salt Lake City, UT 84103-4324 | 2013-07-22 |
| 1932385671 | Suzanne M Yandow | Orthopaedic Surgery | 100 Mario Capecchi Dr, 4550, Salt Lake City, UT 84113-1103 | 2008-01-11 |
| 1154497006 | James W Ogilvie | Orthopaedic Surgery | 1340 E. 300 N., Shriners Hospital for Children, Salt Lake City, UT 84103-4399 | 2006-11-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982141008 | Douglas Kehl | Orthopaedic Surgery | 825 W South Links Dr, Washington, UT 84780-8524 | 2017-01-26 |
| 1104027234 | Lyle Beyer Mason | Orthopaedic Surgery | 1708 Stone Ridge Cir, Bountiful, UT 84010-1033 | 2007-05-29 |
| 1386257152 | University of Utah Pediatric Services | Orthopaedic Surgery | 9385 S Snowbird Center Dr, Sandy, UT 84092-6249 | 2020-08-31 |
| 1497089908 | Utah Orthopaedics LLC | Orthopaedic Surgery | 5782 Adams Avenue Parkway, Washington Terrace, UT 84405 | 2009-09-30 |
| City | SALT LAKE CITY |
| Zip Code | 84103 |
Please comment or provide details below to improve the information on THERESA ANN HENNESSEY.
| 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.