Sevocation Anesthesia, PLLC
Organization Active NPI Anesthesiology Physician · Draper, UT
NPI 1730673252 · NPPES record last updated Oct 29, 2018
Key facts
- NPI
- 1730673252
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 207L00000X
- Legal business name
- SEVOCATION ANESTHESIA, PLLC
- Practice address
- 11925 S State St
Draper, UT 84020-7735 - Phone
- (801) 545-8000
- NPI assigned
- Jun 18, 2018
- Organization subpart
- No
Authorized official
- Name
- Christopher M. Campbell, MD
- Title
- President
- Phone
- (801) 832-1038
Practitioners 14
-
Vainuupo R Jessop, M.D.
-
David B Owen, D.O.
-
Manasa Gill, MD
-
Richard L Glines, M.D.
-
Robert Hibbard, MD
-
Benjamin Metcalfe, D.O.
-
Isaac Cherrington Morris, M.D.
-
Dustin G Morris, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181217003186 | UT | Part B Supplier - Clinic/Group Practice | 6507118015 |
Receives reassigned benefits from 3 practitioners Practice locations: Draper, UT |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes |
Addresses
Primary practice location
11925 S State St
Draper, UT 84020-7735
Mailing address
PO Box 3690
Salt Lake City, UT 84110-3690
Phone (801) 727-2059
Other providers in Draper, UT
- Sequoia Wellness LLC
- Gabriel James Sermon
- Tracey Sermon
- Emily Setser
- Seida Severiano-Campos
- Amanda Seymour
- Rebekah Shackley
- Natalia Shade
- Rina Jay Shah
- Richa Sharma
All providers in Draper, UT · Anesthesiology Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.