Individual provider Active NPI

Elizabeth Demos Nicholson, M.D.

  • Emergency Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1245262229
Registry record updated May 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
6623361-1205 Issued in UT
Practice address
5121 S. Cottonwood Street
Salt Lake City, UT 84157
Phone
(801) 269-2500
Fax
(801) 269-2690
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A86767 CA
Emergency Medicine Physician 207P00000X 6623361-1205 UT Primary
Emergency Medicine Physician 207P00000X 6623361-8905 UT

Addresses

Primary practice location

5121 S. Cottonwood Street
Salt Lake City, UT 84157

Mailing address

PO Box 30180
Salt Lake City, UT 84130-0180
Phone (801) 269-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080128000274 UT Practitioner - Emergency Medicine 6103821459 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Connecticut School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians
Utah Emergency PhysiciansGroup PAC ID 1153307277, 151 clinicians

Practice addresses (Care Compare)

1000 N Main
Sevier Valley Hospital Physicians GRP
Richfield, UT 84701-1843
Phone (435) 893-4100

5121 S Cottonwood St
Salt Lake City, UT 84107-5701
Phone (801) 507-9700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.98 of 100Reported as group
Quality
85.2
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6623361-1205UTMDEmergency Medicine Physician
6623361-8905UTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Mar 1, 2020 Accepting new patients
Utah Emergency Physicians Emergency Medicine CurrentSince Nov 1, 2019 Accepting new patients
Ihc Health Services Inc Family Medicine Current Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Jan 1, 2016 Accepting new patients
University of Utah Adult Services CurrentSince Jan 1, 2016 Accepting new patients
Solano Gateway Medical Group Inc Emergency Medicine Past Accepting new patients

Locations

1000 N Main St
Richfield, UT 84701
Phone (435) 893-4100

3741 W 12600 S
Riverton, UT 84065
Phone (801) 285-2400

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

9660 S 1300 E
Sandy, UT 84094
Phone (801) 314-2417

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

1950 Circle of Hope Dr
Slc, UT 84112
Phone (801) 585-0100

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306195200000",
    "number": "1245262229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30180",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300180",
            "telephone_number": "801-269-2500",
            "fax_number": "801-269-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 S. COTTONWOOD STREET",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84157",
            "telephone_number": "801-269-2500",
            "fax_number": "801-269-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "ELIZABETH",
        "middle_name": "DEMOS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2011-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A86767",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "6623361-1205",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "6623361-8905",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.