| Benjamin Berthold, PMHNP | |
|
5770 S 1500 W, Salt Lake City, UT 84123-5216 | |
| (801) 265-3412 | |
| Not Available |
| Full Name | Benjamin Berthold |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Location | 5770 S 1500 W, Salt Lake City, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235741679 | NPI | - | NPPES |
| Entity Name | TMC Medical Network |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750832283 PECOS PAC ID: 9638457013 Enrollment ID: O20161107000996 |
| Mailing Address | Practice Location Address |
|---|---|
| Benjamin Berthold, PMHNP Po Box 30180, Salt Lake City, UT 84130-0180 Ph: Not Available | Benjamin Berthold, PMHNP 5770 S 1500 W, Salt Lake City, UT 84123-5216 Ph: (801) 265-3412 |
Mrs. Lisa Ann Runyon, CPNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 100 N Medical Dr, Trauma Services, Salt Lake City, UT 84113 Phone: 801-662-2993 Fax: 801-662-2999 |
Madeline Ann Thayer, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 100 N Mario Capecchi Dr, Salt Lake City, UT 84113 Phone: 801-662-3600 |
Ms. Eliza Dansie Parkin, RN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2218 S Dallin St, Salt Lake City, UT 84109 Phone: 801-673-7088 |
Crystal Marshall, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4460 S Highland Dr, Salt Lake City, UT 84124 Phone: 888-949-4864 |
Emma Fong, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3802 S 700 E, Salt Lake City, UT 84106 Phone: 801-264-6000 |
Ashlee Brynn Fenton, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1160 E 3900 S Ste G200, Salt Lake City, UT 84124 Phone: 801-268-7766 |
Ms. Sharon A Korhel, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1105 W 1000 N, Salt Lake City, UT 84116 Phone: 801-408-8626 Fax: 801-364-2436 |