| Utah Gastroenterology Llc | |
|
1187 E 3900 S Salt Lake City UT 84124-1201 | |
| (801) 263-3041 | |
| (801) 263-8485 |
| Full Name | Utah Gastroenterology Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1187 E 3900 S, Salt Lake City, Utah |
| Authorized Official Name and Position | Christine Morris (CORPORATE ADMINISTRATOR) |
| Authorized Official Contact | 8019443191 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Utah Gastroenterology Llc 6360 South 3000 East Suite 220 Salt Lake City UT 84121-6923 Ph: (801) 944-3199 | Utah Gastroenterology Llc 1187 E 3900 S Salt Lake City UT 84124-1201 Ph: (801) 263-3041 |
| NPI Number | 1871689562 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 07/22/2021 |
| Medicare PECOS PAC ID | 9830174150 |
|---|---|
| Medicare Enrollment ID | O20040621001991 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871689562 | NPI | - | NPPES |
| 1026423 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Michael D Cragun |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164528832 PECOS PAC ID: 1052397403 Enrollment ID: I20040625000989 |
| Provider Name | Peter C Fenton |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1952311797 PECOS PAC ID: 1658344163 Enrollment ID: I20040813000513 |
| Provider Name | Gordon E Harmston |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1972516748 PECOS PAC ID: 7618966433 Enrollment ID: I20041013000779 |
| Provider Name | Mark E Boschert |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346252236 PECOS PAC ID: 0345200499 Enrollment ID: I20041013001141 |
| Provider Name | Alvin K Nichols |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1548366347 PECOS PAC ID: 5890755300 Enrollment ID: I20041018001142 |
| Provider Name | Manardie Shimata |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1720099542 PECOS PAC ID: 7113826504 Enrollment ID: I20041111000940 |
| Provider Name | Jason Corwin Wills |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1871689554 PECOS PAC ID: 1052358397 Enrollment ID: I20050408000576 |
| Provider Name | Ron W Pulver |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487665394 PECOS PAC ID: 7214962174 Enrollment ID: I20050928001559 |
| Provider Name | James Bown |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1629081260 PECOS PAC ID: 8123019684 Enrollment ID: I20051119000011 |
| Provider Name | Robert G Jones |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1164465647 PECOS PAC ID: 5890707608 Enrollment ID: I20060619000068 |
| Provider Name | Karen Ann Madigan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740213602 PECOS PAC ID: 0244235299 Enrollment ID: I20060925000558 |
| Provider Name | Roger L Siddoway |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1548240310 PECOS PAC ID: 4284603192 Enrollment ID: I20070112000185 |
| Provider Name | Rock E Harper |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265578553 PECOS PAC ID: 7416051313 Enrollment ID: I20070403000133 |
| Provider Name | Brett W Doxey |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1386775682 PECOS PAC ID: 7315046364 Enrollment ID: I20070615000579 |
| Provider Name | Chaya R Krishnamurthy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1679767842 PECOS PAC ID: 4880789759 Enrollment ID: I20071008000186 |
| Provider Name | Edward John Frech |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1942496757 PECOS PAC ID: 8123192622 Enrollment ID: I20080731000804 |
| Provider Name | Christopher C Canale |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1598952145 PECOS PAC ID: 9931273968 Enrollment ID: I20080808000304 |
| Provider Name | Jeffrey L Bell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992869598 PECOS PAC ID: 1759349327 Enrollment ID: I20081007000594 |
| Provider Name | Layne T Summers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528087848 PECOS PAC ID: 8921136730 Enrollment ID: I20100624000953 |
| Provider Name | David R Moore |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1215969837 PECOS PAC ID: 8729091178 Enrollment ID: I20101006000905 |
| Provider Name | David B Trowbridge |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1134215809 PECOS PAC ID: 1052482262 Enrollment ID: I20101026001213 |
| Provider Name | Kristina M Sparks |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1790931665 PECOS PAC ID: 2668524182 Enrollment ID: I20110328000514 |
| Provider Name | Peder J Pedersen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1568558211 PECOS PAC ID: 4385638246 Enrollment ID: I20110408000725 |
| Provider Name | Travis D Berni |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386898567 PECOS PAC ID: 7012065147 Enrollment ID: I20110526000187 |
| Provider Name | Christopher B Lloyd |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1851538615 PECOS PAC ID: 7810042140 Enrollment ID: I20110816000709 |
| Provider Name | Christopher I Maxwell |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1114107026 PECOS PAC ID: 4587827993 Enrollment ID: I20120523000070 |
| Provider Name | Sean Young |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528483872 PECOS PAC ID: 8820211287 Enrollment ID: I20140603002456 |
| Provider Name | Miquela I Afshar |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1508238551 PECOS PAC ID: 6305146614 Enrollment ID: I20151118000964 |
| Provider Name | Matthew S Saylor |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386685337 PECOS PAC ID: 2860443611 Enrollment ID: I20160316001549 |
| Provider Name | Matthew L Rigby |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1235484981 PECOS PAC ID: 5092966309 Enrollment ID: I20160419002746 |
| Provider Name | Sonia L Klonoski |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821335308 PECOS PAC ID: 7810139490 Enrollment ID: I20161228000348 |
| Provider Name | Emily K Chipping |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1043450554 PECOS PAC ID: 7618010554 Enrollment ID: I20170426002701 |
| Provider Name | Catherine G Rawson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750808150 PECOS PAC ID: 3375809981 Enrollment ID: I20171115002134 |
| Provider Name | Aaron B. Skidmore |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922387174 PECOS PAC ID: 6305017013 Enrollment ID: I20180131002080 |
| Provider Name | Brien Rex Miller |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1992066799 PECOS PAC ID: 1456616127 Enrollment ID: I20180530000552 |
| Provider Name | Robert Stuart Bridge |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1336374909 PECOS PAC ID: 7618109109 Enrollment ID: I20180619003238 |
| Provider Name | Stacey Nelson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912187329 PECOS PAC ID: 8022198050 Enrollment ID: I20200429002354 |
| Provider Name | Erin L Groundland |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972614402 PECOS PAC ID: 5890821953 Enrollment ID: I20210608001824 |
| Provider Name | Lauren L Roser |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1023516333 PECOS PAC ID: 9436419447 Enrollment ID: I20210625001465 |
| Provider Name | Rebecca S Voaklander |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689091977 PECOS PAC ID: 9931468618 Enrollment ID: I20210916002956 |
| Provider Name | Rebeka Charlotte Eslinger |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1871803601 PECOS PAC ID: 7719165497 Enrollment ID: I20211118001485 |
| Provider Name | Joshua P Davis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417465295 PECOS PAC ID: 9931463502 Enrollment ID: I20211202002394 |
| Provider Name | Nekenzie Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649936535 PECOS PAC ID: 9234524505 Enrollment ID: I20220323002007 |
| Provider Name | George Jeung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275982464 PECOS PAC ID: 1658665161 Enrollment ID: I20220512002318 |
| Provider Name | Tara Traczyk |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386032167 PECOS PAC ID: 0345568473 Enrollment ID: I20220615002829 |
| Provider Name | Jennifer Jo Kucifer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184381303 PECOS PAC ID: 4385023324 Enrollment ID: I20220621003096 |
| Provider Name | Daniel Cruttenden |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1083246631 PECOS PAC ID: 7618305475 Enrollment ID: I20220921003447 |
| Provider Name | Ashlee Ann Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770207391 PECOS PAC ID: 3173999190 Enrollment ID: I20221017001880 |
| Provider Name | Allison Venner |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1255592150 PECOS PAC ID: 5890001606 Enrollment ID: I20230111001934 |
| Provider Name | Nathaniel Kwak |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1245674191 PECOS PAC ID: 1153639471 Enrollment ID: I20230412002556 |
| Provider Name | Paula Dobrowolska |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417353319 PECOS PAC ID: 1850614199 Enrollment ID: I20230726001897 |
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