THEOPHILUS E OWAN (NPI# 1982682647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1982682647 |
Entity Type | Individual |
Full Name | THEOPHILUS E OWAN |
Credential | M.D. |
Practice Address |
100 Mario Capecchi Dr Salt Lake City UT 84113-1103 |
Mailing Address |
Po Box 413033 Salt Lake City UT 84141-3033 |
Practice Telephone | 8016625400 |
Mailing Telephone | 8012133900 |
Enumeration Date | 2006-01-04 |
Last Update Date | 2012-09-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
6543761-1205 | UT | Allopathic & Osteopathic Physicians |
Street Address |
100 MARIO CAPECCHI DR |
City | SALT LAKE CITY |
State | UT |
Zip Code | 84113-1103 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033111810 | Andrew Gerald Smith | Legal Medicine | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2005-08-11 |
1235535485 | Ihc Health Services Inc | Clinic/Center | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-11-17 |
1508262833 | Aimee Brierley | Occupational Therapist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-11-13 |
1801290986 | Jeffery Zobell | Pharmacist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-10-17 |
1336542778 | Bevan Jensen | Pharmacist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-09-30 |
1699183152 | Kristina Rogers | Dentist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-07-29 |
1548677297 | Stephanie Eva Wisniewski | Speech-Language Pathologist | 100 Mario Capecchi Dr, Primary Children's Rehab, Salt Lake City, UT 84113-1103 | 2014-07-15 |
1184044877 | Adam Wesley Dell | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-04-21 |
1225456718 | Bhanu Muniyappa | Pediatrics | 100 Mario Capecchi Dr, Pediatrics Residency Program, Salt Lake City, UT 84113-1103 | 2014-04-01 |
1265850952 | Kristina Gulliver | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-03-31 |
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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 | 207RI0011X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Interventional Cardiology |
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
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1386272755 | Advanced Vein and Vascular of Salt Lake City LLC | Internal Medicine | 6321 S Redwood Rd Ste 102, Salt Lake City, UT 84123-6799 | 2020-03-31 |
1114361136 | Lee Anthony Linstroth | Internal Medicine | 30 N 1900 E, Room 4c104, Salt Lake City, UT 84132-0002 | 2013-04-21 |
1437446168 | Mountainstar Cardiology St Marks LLC | Internal Medicine | 1160 E 3900 S, Ste. 2000, Salt Lake City, UT 84124-1202 | 2011-07-01 |
1770720534 | Zubair Cardiovascular Inc | Internal Medicine | 82 South 1100 East, Suite 402, Salt Lake City, UT 84102 | 2009-01-15 |
1629221841 | Eric M Lindley | Internal Medicine | University of Utah, Salt Lake City, UT 84132-0001 | 2008-10-31 |
1255591194 | Vamsee Mohan Yaganti | Internal Medicine | 1160 E 3900 S Ste 2000, Salt Lake City, UT 84124-1236 | 2008-06-13 |
1154538148 | Anwar Tandar | Internal Medicine | 30 N 1900 E, University of Utah Hospital, Salt Lake City, UT 84132-0002 | 2007-05-17 |
1134219769 | William Harvey Barry | Internal Medicine | 50 N Medical Dr, Cardiology Division, Salt Lake City, UT 84132-0001 | 2006-10-13 |
1922058064 | Cardiovascular Consultants of Utah PC | Internal Medicine | 24 S 1100 E, Suite 304, Salt Lake City, UT 84102-1500 | 2006-05-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700490133 | Advanced Vein and Vascular of Northern Utah LLC | Internal Medicine | 810 S 100 W Ste 120, Logan, UT 84321-5845 | 2020-09-02 |
1326679952 | Advanced Vein and Vascular of Southern Utah LLC | Internal Medicine | 1251 Northfield Rd # 103, Cedar City, UT 84721-8622 | 2020-02-02 |
1407851488 | Tareq S Harb | Internal Medicine | 4403 Harrison Blvd Ste 3490, Ogden, UT 84403-3284 | 2005-06-16 |
1093329427 | Advanced Vein and Vascular of Utah Valley LLC | Internal Medicine | 320 River Park Dr Ste 125, Provo, UT 84604-6065 | 2020-09-02 |
1396390316 | American Heart and Vascular Institute PC | Internal Medicine | 5801 S Fashion Blvd Ste 120, Murray, UT 84107-8115 | 2019-08-06 |
1417283359 | Canyon Crest Heart & Health L.L.C. | Internal Medicine | 11762 S State St, Draper, UT 84020-7155 | 2009-10-28 |
1235330382 | Sohail Khan | Internal Medicine | 5405 S 500 E Ste 204, Ogden, UT 84405-7420 | 2007-05-29 |
1710010343 | Arabindra Bahadur Katwal | Internal Medicine | 5405 S 500 E Ste 204, Ogden, UT 84405-7420 | 2007-03-13 |
1477698223 | Ihc Health Services Inc | Internal Medicine | 1380 E Medical Center Dr, Suite 1500, St George, UT 84790-2123 | 2007-02-20 |
1689631913 | Mark William Pulsipher | Internal Medicine | 1380 E Medical Center Dr, Suite 1500, St George, UT 84790-2123 | 2006-04-28 |
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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.