UNIVERSITY OF UTAH PEDIATRIC ACUITY CARE (NPI# 1891156741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891156741 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF UTAH PEDIATRIC ACUITY CARE |
| Other Organization Name | PRIMARY CHILDREN'S HOSPITAL - PEDIATRIC CRITICAL CARE |
| Practice Address |
100 N Mario Capecchi Dr Salt Lake City UT 84113-1103 |
| Mailing Address |
Po Box 841450 Los Angeles CA 90084-1450 |
| Practice Telephone | 8015876336 |
| Mailing Telephone | 8012133900 |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2020-05-20 |
| Authorized Official Name | EDWARD CLARK (DEPARTMENT CHAIR) |
| Authorized Official Telephone | 8015876336 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | UNIVERSITY OF UTAH PEDIATRIC ACUITY CARE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Primary Children's Hospital - Pediatric Critical Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851898365 | University of Utah Pediatric Acuity Care | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2018-04-11 |
| 1619325131 | University of Utah Pediatric Acuity Care | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-05-25 |
| 1376907410 | University of Utah Pediatric Acuity Care | Pediatrics | 3741 W 12600 S, Riverton, UT 84065-7215 | 2016-04-05 |
| 1538523675 | University of Utah Pediatric Acuity Care | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-04-05 |
| 1770947814 | University of Utah Pediatric Acuity Care | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-04-05 |
| 1558723445 | University of Utah Pediatric Acuity Care | Psychiatry & Neurology | 501 S Chipeta Way, Salt Lake City, UT 84108-1222 | 2016-03-22 |
| 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 |
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| 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 | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, 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. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942642541 | Elizabeth Quigley | Pediatrics | 515 E 100 S Ste 200, Salt Lake City, UT 84102-2095 | 2013-07-23 |
| 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 |
| 1588634729 | William Bradley Poss | Pediatrics | 295 E Chipeta Way, Salt Lake City, UT 84108-1287 | 2006-01-23 |
| 1174056758 | Andrew Daniel Fontes | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2017-04-10 |
| 1457883449 | Lauren Burgunder | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2017-03-30 |
| 1669866133 | Angela Coker | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84108 | 2015-03-23 |
| 1801216957 | Kevin Hummel | Pediatrics | 30 N 1900 E # 1c412, Salt Lake City, UT 84132-9760 | 2014-04-16 |
| 1972842813 | Tighe Nicholas Marrone | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2013-02-13 |
| 1801153358 | Erin Bennett | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113 | 2012-04-20 |
| 1619119203 | Hillary Ann Crandall | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2009-03-30 |
| Find all providers in SALT LAKE CITY | ||||
| 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.