Edmund A Liles Jr., MD
Individual provider Active NPI Hospitalist Physician · Salt Lake City, UT
NPI 1831114123 · NPPES record last updated Aug 12, 2022
Key facts
- NPI
- 1831114123
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Hospitalist Physician 208M00000X
- License
- 12777047-1205 (UT)
- Practice address
- 50 N Medical Dr
Salt Lake City, UT 84132-7085 - Phone
- (801) 581-2121
- NPI assigned
- Jul 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 19
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Hospitalist
- Education
- University of North Carolina at Chapel Hill School of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University of Utah Adult Services
Practice addresses (Care Compare)
50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 585-6387
Hospital & facility affiliations
- University of Utah Hospital and Clinics
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NC, UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040416000999 | NC | Practitioner - Hospitalist |
2860487105 | Reassigns benefits to 1 organization |
| I20220609002630 | UT | Practitioner - Hospitalist |
2860487105 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah Adult Services | Current |
Accepting new patients | |
| University of Utah Adult Services | Current |
Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| University of Utah Pediatric Services | Current |
Accepting new patients | |
| Chatham Medical Specialists PA | Internal Medicine | Current | Accepting new patients |
| University of Utah Pediatric Services | Current | Accepting new patients | |
| University of Utah Pediatric Services | Current |
Accepting new patients | |
| Chatham Hospital, Inc. | Current |
Accepting new patients | |
| The University of North Carolina at Chapel Hill | Past | Accepting new patients | |
| University of North Carolina at Chapel Hill | Past | Accepting new patients | |
| University Internal Medicine at Chapel Hill North Medical Center | Internal Medicine | Past | Accepting new patients |
| University of North Carolina at Chapel Hill | Past | Accepting new patients | |
| Wakemed Faculty Practice Plan | Internal Medicine | Past | Accepting new patients |
| Wakemed Faculty Practice Plan | Hospitalist | Past | Accepting new patients |
Locations
101 Manning Dr
#7085
Chapel Hill, NC 27514
Phone (984) 974-1903
101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485
475 Progress Blvd
Siler City, NC 27344
Phone (919) 799-4000
127 S 500 E
Ste 200B
Salt Lake City, UT 84102
127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
1950 Circle of Hope Dr
Slc, UT 84112
Phone (801) 585-0100
100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109
Interoperability endpoints
- eliles588453@direct.med.utah.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 9701460 | NC | |
| Internal Medicine Physician | 207R00000X | 12777047-1205 | UT | |
| Hospitalist Physician | 208M00000X | 9701460 | NC | |
| Hospitalist Physician | 208M00000X | 12777047-1205 | UT | Yes |
Addresses
Primary practice location
50 N Medical Dr
Salt Lake City, UT 84132-7085
Mailing address
30 N 1900 E # 5R218
Salt Lake City, UT 84132-0002
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891256A | Medicaid | NC |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | aliles3448@direct.UNC.nchie.net | Direct | |
| Direct Messaging Address | ELILES588453@DIRECT.MED.UTAH.EDU | Direct | University of Utah |
Other providers in Salt Lake City, UT
- Thomas Ligman V
- Darwinna Ligones
- Lihai Medical Clinic Inc
- Lilac Dentistry
- Lilac Wellness PLLC
- Krista Liles
- Rilla Annette Liles
- Elisabeth Thomas Lilja
- Kristen Hansord Lilja
- Brian B Liljenquist
All providers in Salt Lake City, UT · Hospitalist 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 Aug 12, 2022. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.