DR. JONATHAN ROBERT EISENBERG (NPI# 1811350325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811350325 |
| Entity Type | Individual |
| Full Name | DR. JONATHAN ROBERT EISENBERG |
| Credential | MD |
| Practice Address |
295 S Chipeta Way Salt Lake City UT 84108-1287 |
| Practice Telephone | 8015877450 |
| Mailing Telephone | 8015877450 |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2019-06-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0204X |
Pediatrics Specialization: Pediatric Emergency Medicine |
11250300-1205 | UT | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1800 Orleans St. Rm 8446, Bloomberg Childrens Center, Baltimore, MD 212870010 | 4109555000 | 4105500967 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689055113 | Jonathan David Eisenberg | Internal Medicine | 75 Francis St, Boston, MA 02115 | 2015-06-10 |
| Street Address |
295 S CHIPETA WAY |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84108-1287 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346248465 | Justin Charles Alvey | Pediatrics | 295 S Chipeta Way, University of Utah Department of Pediatrics, Salt Lake City, UT 84108-1287 | 2005-07-12 |
| 1912535501 | Margaret Jean Bale | Student in an Organized Health Care Education/Training Program | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2020-03-30 |
| 1376183582 | Claire Ann Goeke | Nurse Practitioner | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2020-01-15 |
| 1528544012 | Ashley Berrett | Dietitian, Registered | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2018-07-17 |
| 1588184105 | Samuel B. Zoucha | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84132-1287 | 2017-06-24 |
| 1114457413 | Adrienne Cohen | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84132-1287 | 2017-06-19 |
| 1447780119 | Christine Morris | Physician Assistant | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2017-06-15 |
| 1023545670 | Natalie Justine Tedford | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2017-05-15 |
| 1356876858 | Allison M. Fisher | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84132-1287 | 2017-04-22 |
| 1174056758 | Andrew Daniel Fontes | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2017-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548753056 | Maxine Ht Erickson | Assistant Behavior Analyst | 780 Guardsman Way, Salt Lake City, Ut 84108, Salt Lake City, USA 84108 | 2018-06-08 |
| 1841704061 | Robyn Carver | Occupational Therapist | 421 Wakara Wat, Salt Lake City, UT 84108 | 2017-11-27 |
| 1518478742 | Lcr Dental Sugar House | Dentist | 2068 S 2100 E Suite #a, Salt Lake City, UT 84108 | 2017-10-16 |
| 1447708912 | Aubrianne Squire Evans | Occupational Therapist | 421 S Wakara Way Ste 201, Salt Lake City, UT 84108 | 2016-09-14 |
| 1629524426 | Ryan Weisenbeck | Specialist/Technologist | 580 S Guardsman Way, Salt Lake City, UT 84108 | 2016-08-31 |
| 1164885547 | Michael Fazzone | Student in an Organized Health Care Education/Training Program | 530 South Wakara Way, University of Urah, School of Dentistry, Salt Lake City, UT 84108 | 2016-04-01 |
| 1669833489 | Bryon Claflin | Registered Nurse | 650 S Komas Ste 200, Salt Lake City, UT 84108 | 2016-03-08 |
| 1801283833 | Autism Assement Treatment Program Adult | Psychologist | 650 S Komas, Suite 200, Salt Lake City, UT 84108 | 2015-04-16 |
| 1578993275 | Matthew and David Dental Pllc | Dentist | 1355 Foothill Drive, Salt Lake City, UT 84108 | 2013-11-15 |
| 1841631520 | Deepika Garg | Internal Medicine | 675 S Arapeen Dr Ste 205, Salt Lake City, UT 84108 | 2013-07-10 |
| Find all providers in zip 84108 | ||||
| Taxonomy Code | 2080P0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Emergency Medicine |
| A pediatrician who has special qualifications to manage emergencies in infants and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023545670 | Natalie Justine Tedford | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2017-05-15 |
| 1437513926 | University of Utah Pediatric Services | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-04-11 |
| 1538523675 | University of Utah Pediatric Acuity Care | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-04-05 |
| 1255795399 | University of Utah Pediatric Services | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-04-05 |
| 1295121184 | Tiana Monostory | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2015-04-08 |
| 1568889541 | Cheryl Yang | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2014-03-27 |
| 1811230378 | Sydney Ryan | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2013-04-03 |
| 1245524651 | Pediatric Emergency Sedation Service | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2011-06-02 |
| 1184915217 | Rachel Elizabeth Whitney | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2011-04-24 |
| 1437458221 | Chari D. Larsen | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2011-03-20 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84108 |
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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.