DR. JEFFREY GUS ERICKSON (NPI# 1902850894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902850894 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY GUS ERICKSON |
| Credential | MD |
| Practice Address |
50 N Medical Dr Salt Lake City UT 84132-0001 |
| Mailing Address |
295 Chipeta Way Ped Admin Salt Lake City UT 84108-1220 |
| Practice Telephone | 8015813501 |
| Practice Fax Number | 8015813899 |
| Mailing Telephone | 8015812321 |
| Mailing Fax Number | 8015813899 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 5784394-1205 | UT | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760552905 | Jeffrey Allan Erickson | Physical Therapist | 242 Old New Brunswick Rd Ste 3003, Piscataway, NJ 08854 | 2006-11-08 |
| 1083926356 | Jeffrey Hildor Erickson | Dentist | 6701 W Union Hills Dr, Glendale, AZ 85308 | 2010-07-02 |
| 1538484613 | Jeffrey Erickson | Counselor | 3444 Wisconsin Ave, Vicksburg, MS 39180-5331 | 2010-04-01 |
| 1306088141 | Jeffrey Lee Erickson | Psychiatry & Neurology | 1200 N State St, Los Angeles, CA 90033-1029 | 2009-03-25 |
| 1053451435 | Jeffrey M Erickson | Dentist | 20265 Lake Chabot Rd, Castro Valley, CA 94546-5307 | 2007-02-07 |
| 1447308580 | Jeffrey Dean Erickson | Social Worker | 1919 University Ave W, 200, Saint Paul, MN 55104-3453 | 2007-01-08 |
| 1487719209 | Jeffrey D. Erickson | Dentist | 8900 Penn Ave S, 105, Bloomington, MN 55431-2068 | 2006-12-22 |
| 1801963178 | Jeffrey Erickson | Dentist | 7305 N. Military Trail, Dental Service (160), West Palm Beac, FL 33410 | 2006-11-29 |
| 1194708438 | Jeffrey T. Erickson | Dentist | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2005-11-21 |
| Street Address |
50 N MEDICAL DR |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84132-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477555696 | Yaw Ababio Boateng | Internal Medicine | 50 N Medical Dr, Salt Lake City, UT 84132-0100 | 2005-06-01 |
| 1073114864 | Stephanie Bevill | Registered Nurse | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-11-06 |
| 1609477801 | Justin Larson | Physical Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-11-04 |
| 1366042467 | Kirsty Aleah Vannoy | Occupational Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-10-28 |
| 1629675673 | Erica Kueneman | Nurse Practitioner | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-10-02 |
| 1487266680 | Michelle A Barker | Physical Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-08-19 |
| 1770195943 | Lisa M Schaeffer | Nurse Practitioner | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-08-19 |
| 1194336289 | Michelle Rios | Physical Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-08-12 |
| 1932710027 | Tanner Ladsten | Physical Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-08-12 |
| 1578174660 | Rachel Sette | Occupational Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-08-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275162331 | Scott Andrew Rizzi | Student in an Organized Health Care Education/Training Program | 30 North 1900 East Som 4c116, Salt Lake City, UT 84132 | 2020-04-02 |
| 1609421403 | Monika Fleckenstein | Ophthalmology | 65 Mario Capecchi Drive, John A. Moran Eye Center, Salt Lake City, UT 84132 | 2019-08-08 |
| 1366975914 | Jacob Brandenburg | Anesthesiology | School of Medicine 30 North 1900 East Room 3c444, Salt Lake City, UT 84132 | 2017-04-10 |
| 1568815082 | Anastasia Neufeld | Ophthalmology | 65 Mario Capecchi Drive, Salt Lake City, UT 84132 | 2016-07-20 |
| 1912350083 | Gmaan Alzhrani | Student in an Organized Health Care Education/Training Program | 175 N. Medical Drive East , Salt Lake City, UT 84132 | 2016-07-13 |
| 1831544600 | Drew Goerke | Occupational Therapist | 50 N Medical Drive, Som Room #1r73, Salt Lake City, UT 84132 | 2016-04-29 |
| 1891179024 | Bong Jik Kim | Student in an Organized Health Care Education/Training Program | 50 North Medical Drive 3c120, Otolaryngology Administration Office, Salt Lake City, UT 84132 | 2015-07-17 |
| 1043699101 | Chris Anderson | Physician Assistant | 30 North 1900 East #3c344, Salt Lake City, UT 84132 | 2015-05-22 |
| 1689061822 | Ryan Clark | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 30 N 1900 E Som 3c127, Salt Lake City, UT 84132 | 2015-04-24 |
| 1649666264 | Kevin Conrad | Anesthesiology | 30 N 1900 E Room 3c444, Salt Lake City, UT 84132 | 2015-04-09 |
| Find all providers in zip 84132 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619430303 | Hailey N. Baisch | Pediatrics | 81 N Mario Capecchi Dr Rm 1a.001, Salt Lake City, UT 84113-1125 | 2019-04-09 |
| 1811415565 | Community Health Centers, Inc. | Pediatrics | 324 Tenth Ave Ste 249, Salt Lake City, UT 84103-2889 | 2017-09-01 |
| 1033566658 | Kathryn Eleanor Curry Gradick | Pediatrics | University of Utah 50 North Medical Drive, Salt Lake City, UT 84132-0001 | 2016-05-24 |
| 1134582935 | Bradley Kramer | Pediatrics | 1140 E 3900 S Ste 360, Salt Lake City, UT 84124-1247 | 2016-03-30 |
| 1831523828 | Max Shaw Perelman | Pediatrics | 515 E 100 S, Suite 200, Salt Lake City, UT 84102-4211 | 2013-08-26 |
| 1780950147 | Jonathan Wheatley Schmidt | Pediatrics | University of Utah 30 N 900 E, Salt Lake City, UT 84132-0001 | 2012-03-29 |
| 1942508619 | Charles Elliott Richards | Pediatrics | 767 Sunrise Ave, Salt Lake City, UT 84103-3735 | 2011-03-04 |
| 1922331479 | David Ray Thomas | Pediatrics | 2795 Casto Ln, Salt Lake City, UT 84117-6304 | 2009-09-16 |
| 1417101882 | Scott Szucs Carleton | Pediatrics | 1225 3rd Ave, Salt Lake City, UT 84103-4338 | 2008-11-11 |
| 1063665032 | Jennifer Goldman Luthy | Pediatrics | University Pediatric Clinic, 50 N Medical Drive, Salt Lake City, UT 84132-0001 | 2008-11-04 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84132 |
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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.