Active NPI
Elyse Frances Coolidge, M.D.
- Child & Adolescent Psychiatry Physician
- Salt Lake City, UT
National Provider Identifier
1265842579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 11320286-1205
- Practice address
- 2666 S 2000 E Ste 101
Salt Lake City, UT 84109-1721 - Phone
- (801) 864-4077
- NPI assigned
- May 8, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 11320286-1205 | UT | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 11320286-1205 | UT | Primary |
Addresses
Primary practice location
2666 S 2000 E Ste 101
Salt Lake City, UT 84109-1721
Mailing address
2666 S 2000 E Ste 101
Salt Lake City, UT 84109-1721
Phone (801) 864-4077
Other practice location 1
266 Left Fork Hobble Creek Canyon Road
Springville, UT 84663
Phone (385) 500-3529
Other names 1
- Elyse Coolidge Huey
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11320286-1205 | UT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PHC of Utah, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718064000000",
"number": "1265842579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2666 S 2000 E STE 101",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841091721",
"telephone_number": "801-864-4077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2666 S 2000 E STE 101",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841091721",
"telephone_number": "801-864-4077"
}
],
"practiceLocations": [
{
"address_1": "266 Left Fork Hobble Creek Canyon Road",
"address_purpose": "LOCATION",
"city": "Springville",
"state": "UT",
"postal_code": "84663",
"country_code": "US",
"telephone_number": "385-500-3529",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COOLIDGE",
"first_name": "ELYSE",
"middle_name": "FRANCES",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-08",
"last_updated": "2024-06-11",
"certification_date": "2024-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "UT",
"license": "11320286-1205",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "UT",
"license": "11320286-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELYSE",
"last_name": "HUEY",
"middle_name": "COOLIDGE",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.