DR. CAITLIN GANNON PETERSON (NPI# 1760742530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760742530 |
| Entity Type | Individual |
| Full Name | DR. CAITLIN GANNON PETERSON |
| Other Name | CAITLIN REBECCA GANNON |
| Credential | DO |
| Practice Address |
100 N Mario Capecchi Dr Salt Lake City UT 84113-1103 |
| Mailing Address |
Po Box 30180 Salt Lake City UT 84130-0180 |
| Practice Telephone | 8016621000 |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2019-10-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0210X |
Pediatrics Specialization: Pediatric Nephrology |
10784090-1204 | UT | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356811608 | Caitlin Marie Peterson | Specialist/Technologist | 15708 Wood Knoll Lane, Minnetonka, MN 55345 | 2018-11-29 |
| 1528621356 | Caitlin Peterson | Counselor | 320 S Spruce St, Kenai, AK 99611-7939 | 2019-04-17 |
| 1396240586 | Caitlin Peterson | Dietitian, Registered | 4701 Montgomery Blvd Ne, Albuquerque, NM 87109-1219 | 2018-03-28 |
| 1568977957 | Caitlin Marie Peterson | Nurse's Aide | 165 E Hawthorne Ave, Colville, WA 99114-2629 | 2017-12-06 |
| 1376093450 | Caitlin Peterson | Specialist/Technologist | 2646 Patterson Rd Ste A, Grand Junction, CO 81506-1941 | 2016-10-12 |
| 1467881680 | Caitlin Peterson | Social Worker | 155 Chestnut St, Nutley, NJ 07110-2311 | 2013-11-07 |
| Street Address |
100 N MARIO CAPECCHI DR |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84113-1103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750346607 | Paul Krakovitz | Otolaryngology | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2006-04-20 |
| 1417565839 | Gabriel Dunya | Student in an Organized Health Care Education/Training Program | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2020-07-22 |
| 1588281000 | Alexandra Almberg | Nurse Practitioner | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2020-06-30 |
| 1538781224 | Adam Hine | Dentist | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2020-05-15 |
| 1790306488 | Leslie Goltra | Pharmacist | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2020-05-04 |
| 1194345512 | Perry Alana Chapman | Dietitian, Registered | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2020-04-26 |
| 1437779410 | Sandra Benson Johnson | Registered Nurse | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2020-04-20 |
| 1720608078 | Alison Mae Armstrong | Student in an Organized Health Care Education/Training Program | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2020-04-16 |
| 1295354850 | Katie Lynn Lahue | Music Therapist | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2020-04-14 |
| 1790314144 | Danielle Armstrong | Registered Nurse | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2020-04-07 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 84113 | ||||
| Taxonomy Code | 2080P0210X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Nephrology |
| A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487018057 | University of Utah Pediatric Services | Pediatrics | 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 | 2016-04-11 |
| 1346364429 | Matthew Michael Grinsell | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2007-03-16 |
| 1972682540 | Raoul Devin Nelson | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2006-11-03 |
| 1205915873 | Joseph Robert Sherbotie | Pediatrics | 100 N Medical Dr, Salt Lake City, UT 84113-1103 | 2006-11-03 |
| 1053357251 | Meredith L. Seamon | Pediatrics | 100 Mario Capecchi Dr, University of Utah- Department of Pediatrics, Salt Lake City, UT 84113-1103 | 2006-06-22 |
| City | SALT LAKE CITY |
| Zip Code | 84113 |
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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.