STEWART L ELLINGTON MD PC (NPI# 1922315084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922315084 |
| Entity Type | Organization |
| Organization Name | STEWART L ELLINGTON MD PC |
| Practice Address |
24 South1100 East Suite 103 Salt Lake City UT 84102 |
| Practice Telephone | 8013645767 |
| Practice Fax Number | 8015319704 |
| Mailing Telephone | 8013645767 |
| Mailing Fax Number | 8015319704 |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2010-09-09 |
| Authorized Official Name | DR. STEWART L ELLINGTON (PHYSICIAN) |
| Authorized Official Telephone | 8013645767 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 156919-1205 | UT | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 240662791005 | 05 |
| Street Address |
24 SOUTH1100 EAST SUITE 103 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84102 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437533932 | Krystal Ahlstrom | Specialist | 544 E Wilmington Ave, Salt Lake City, UT 84106-1419 | 2015-07-14 |
| 1528460607 | John Miller Holman Jr. | Specialist | 4765 S Ichabod St, Salt Lake City, UT 84117-6461 | 2014-09-21 |
| 1750795423 | Judy Denise Wall | Specialist | 4425 S Camille St, Salt Lake City, UT 84124-3624 | 2014-06-20 |
| 1821434424 | Robert Bradley Wray | Specialist | 2665 E. Parleys Way, #204, Salt Lake City, UT 84109-1672 | 2013-05-22 |
| 1295170850 | Rodolphe Ruffy | Specialist | 4228 S Park Terrace Dr, Salt Lake City, UT 84124-3417 | 2013-05-08 |
| 1063857159 | Afshin Ahmadiyan | Specialist | 2431 E Catalina Dr, Salt Lake City, UT 84121-3939 | 2013-05-03 |
| 1508112426 | Floyd Jackson Millet | Specialist | 2015 Scenic Dr, Salt Lake City, UT 84108-3317 | 2012-07-29 |
| 1386904043 | David Earl Moore | Specialist | 500 Foothill Blvd (research), George E. Wahlen Va Healthcare System, Salt Lake City, UT 84148 | 2012-05-29 |
| 1437422995 | Brent Farr Robertson | Specialist | 1321 E South Temple, 5, Salt Lake City, UT 84102-1830 | 2012-02-14 |
| 1861787756 | William Halls | Specialist | 171 3rd Ave, # 310, Salt Lake City, UT 84103-5006 | 2011-06-18 |
| 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.