LISA MARIE GRAVELLE (NPI# 1821028820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821028820 |
| Entity Type | Individual |
| Full Name | LISA MARIE GRAVELLE |
| Other Name | LISA M. GRAVELLE |
| Credential | M.D. |
| Practice Address |
333 S 900 E Salt Lake City UT 84102-2310 |
| Practice Telephone | 8015358163 |
| Practice Fax Number | 8013554011 |
| Mailing Telephone | 8015358163 |
| Mailing Fax Number | 8013554011 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 5640031-1205 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
333 S 900 E |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84102-2310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053347765 | Russell Jon Ord | Otolaryngology | 333 S 900 E, Salt Lake City, UT 84102-2310 | 2006-06-24 |
| 1962749473 | Chelsie Coates | Registered Nurse | 333 S 900 E, Salt Lake City, UT 84102-2310 | 2013-01-04 |
| 1952631772 | Ihc Health Services Inc. | Clinic/Center | 333 S 900 E, Salt Lake City, UT 84102-2310 | 2009-12-29 |
| 1356550578 | Darci Stapley | Dietitian, Registered | 333 S 900 E, Salt Lake City, UT 84102-2310 | 2007-05-22 |
| 1073642757 | Ihc Health Services Inc | Radiology | 333 S 900 E, Salt Lake City, UT 84102-2310 | 2007-03-05 |
| 1629107305 | Ihc Health Services Inc | Dermatology | 333 S 900 E, Salt Lake City, UT 84102-2310 | 2007-03-05 |
| 1972631042 | Ihc Health Services Inc | Radiology | 333 S 900 E, Salt Lake City, UT 84102-2310 | 2007-03-01 |
| 1356414650 | Charles R Sokol | Pharmacist | 333 S 900 E, Salt Lake City, UT 84102-2310 | 2006-11-16 |
| 1619047743 | Mark Charles Foote | Psychiatry & Neurology | 333 S 900 E, Salt Lake City, UT 84102-2310 | 2006-11-08 |
| 1821173774 | John Wallace Mcmurray | Pharmacist | 333 S 900 E, Salt Lake City, UT 84102-2310 | 2006-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942818604 | Wendy Vazquez | Behavior Technician | 515 S 700 E Suit 2a, Salt Lake City, UT 84102 | 2020-07-20 |
| 1407481245 | Odyssey House Inc | Family Medicine | 743 E 300 S, Salt Lake City, UT 84102 | 2020-03-11 |
| 1093359960 | Hayle Mayer | Behavior Technician | 515 S 700 E Salt Lake City, Suite 2a, Salt Lake, UT 84102 | 2019-11-04 |
| 1326680869 | Ronald Mcdonald House of The Intermountain Area | Meals | 935 E. South Temple, Salt Lake City, UT 84102 | 2019-10-16 |
| 1508419581 | Claire Pemberton | Behavior Technician | 327 E 1300 S, Apt 2, Salt Lake City, UT 84102 | 2019-07-19 |
| 1558923144 | Olivia Anne Hardwick | Social Worker | Transitions At Slrmc, 86 S. 1100 E. Suite 404, Salt Lake City, UT 84102 | 2019-07-03 |
| 1649741802 | Colten Vancampen | Behavior Technician | 515 S 700 E #2a, Salt Lake City, UT 84102 | 2018-12-16 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1104311661 | Malorey Kooyman | Behavior Technician | 515 700 East, Suite 2a, Salt Lake City, UT 84102 | 2018-06-27 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| Find all providers in zip 84102 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| 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 Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144753013 | Jessica Kaplan | Obstetrics & Gynecology | University of Utah University Hospital, 50 N Medical Drive, Salt Lake City, UT 84132-0001 | 2017-04-07 |
| 1326571621 | Kylie Measom Soffe | Obstetrics & Gynecology | Ob Gyn Administration 30 N 1900 E Rm 2b200, Salt Lake City, UT 84132-2101 | 2017-04-04 |
| 1639564016 | Kristen Hansord Lilja | Obstetrics & Gynecology | 82 S 1100 E Ste 305, Salt Lake City, UT 84102-4703 | 2015-04-01 |
| 1194119172 | Irina Cassimatis | Obstetrics & Gynecology | University of Utah Obgyn Dept, 30 N 1900 East. Room 2b200, Salt Lake City, UT 84132-0001 | 2015-03-26 |
| 1033509740 | Kathryn Fay | Obstetrics & Gynecology | 30 N 1900 E Rm 2a200, Salt Lake City, UT 84132-2209 | 2015-02-02 |
| 1932528676 | Aliye Runyan | Obstetrics & Gynecology | 30 North 1900 East 2a200, Dept of Obgyn, Salt Lake City, UT 84132 | 2014-04-09 |
| 1467870295 | Ashley Elizabeth Benson | Obstetrics & Gynecology | 30 N 9100 E, Room 2b200, Salt Lake City, UT 84132-0001 | 2014-03-29 |
| 1386088706 | Michelle Lynne Precourt Debbink | Obstetrics & Gynecology | 30 N 1900 E # 2a200, Salt Lake City, UT 84132-5000 | 2013-04-29 |
| 1427300938 | Nathan R Blue | Obstetrics & Gynecology | 30 N 1900 E # 2b200, Salt Lake City, UT 84132 | 2012-10-08 |
| 1417216516 | Robert Lee Dood | Obstetrics & Gynecology | University of Utah Health, Dept of Obgyn, 30 N 1900 E, Rm 2b200, Salt Lake City, UT 84132 | 2012-05-09 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84102 |
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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.