Active NPI
Adam R Krommenhoek, MD
- Emergency Medical Services (Emergency Medicine) Physician
- Provo, UT
National Provider Identifier
1003863770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician
- License
- 58244501205
- Practice address
- 1034 N 500 W
Provo, UT 84604-3380 - Phone
- (801) 373-7850
- NPI assigned
- May 28, 2006
- Last updated
- Nov 21, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 58244501205 | UT | Primary |
Addresses
Primary practice location
1034 N 500 W
Provo, UT 84604-3380
Mailing address
PO Box 10
Spanish Fork, UT 84660-0010
Phone (866) 898-7136
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00249192 | Other | RAILROAD MEDICARE | |
| 58244501200001 | Other | BCBS | |
| D6138 | Medicaid | UT |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58244501205 | UT | MD | Emergency Medical Services (Emergency Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Utah Valley Emergency Physicians Inc | Emergency Medicine | Current | Accepting new patients |
| Glendale Urgent Care LLC | Past | Accepting new patients | |
| Shea Urgent Care LLC | Past | Accepting new patients | |
| Avondale Urgent Care LLC | Past | Accepting new patients | |
| Pinnacle Medicine Inc. | Past | Accepting new patients | |
| Greenway Urgent Care LLC | Past | Accepting new patients | |
| Dana Landing Urgent Care LLC | Past | Accepting new patients | |
| Desert Ridge Urgent Care LLC | Past | Accepting new patients | |
| Chandler Urgent Care LLC | Past | Accepting new patients | |
| Sun City Urgent Care LLC | Past | Accepting new patients |
Locations
331 N 400 W
Orem, UT 84057
Phone (801) 224-4080
1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119
Organizations & group practices 10
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- Provo, UT
- NPI 1649204553
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290297600000",
"number": "1003863770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10",
"city": "SPANISH FORK",
"state": "UT",
"postal_code": "846600010",
"telephone_number": "866-898-7136",
"fax_number": "616-975-9824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1034 N 500 W",
"city": "PROVO",
"state": "UT",
"postal_code": "846043380",
"telephone_number": "801-373-7850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KROMMENHOEK",
"first_name": "ADAM",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-28",
"last_updated": "2010-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "UT",
"license": "58244501205",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00249192",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "58244501200001",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D6138",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.