Individual provider Active NPI

Kelley Diane Irmen

  • Clinical Social Worker
  • Layton, UT
National Provider Identifier
1003268335
Registry record updated Feb 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10074151-3502 Issued in UT
Practice address
934 S Main St
Layton, UT 84041-7135
Phone
(801) 773-7060
NPI assigned
Jul 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 10074151-3502 UT Primary

Addresses

Primary practice location

934 S Main St
Layton, UT 84041-7135

Mailing address

934 S Main St
Layton, UT 84041-7135
Phone (801) 773-7060

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240627002280 UT Practitioner - Clinical Social Worker 1658815964 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10074151-3502UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Karen W. Malm, PH.D., P.C. CurrentSince May 1, 2024 Accepting new patients

Locations

934 S Main St
Layton, UT 84041
Phone (801) 336-1845

5689 S Redwood Rd
Ste 27
Taylorsville, UT 84123
Phone (801) 266-2485

5689 S Redwood Rd
Unit 27
Taylorsville, UT 84123
Phone (801) 266-2485

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": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519603200000",
    "number": "1003268335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "934 S MAIN ST",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840417135",
            "telephone_number": "801-773-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "934 S MAIN ST",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840417135",
            "telephone_number": "801-773-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRMEN",
        "first_name": "KELLEY",
        "middle_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2018-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "10074151-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.