Individual provider Active NPI

Kimberly Pohlman, PA

  • Physician Assistant
  • North Ogden, UT
National Provider Identifier
1003898149
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12422287-1206 Issued in UT
Practice address
2400 N Washington Blvd
North Ogden, UT 84414-7233
Phone
(801) 786-7500
NPI assigned
Nov 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12422287-1206 UT Primary
Medical Physician Assistant 363AM0700X 152511 OR

Addresses

Primary practice location

2400 N Washington Blvd
North Ogden, UT 84414-7233

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 786-7500

Other identifiers 1

IdentifierTypeStateIssuer
Q53565OtherORUPIN

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220228000462 UT Practitioner - Physician Assistant 1456377811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

4401 Harrison Blvd
Ogden, UT 84403-3195

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
12422287-1206UTMDPhysician Assistant
152511ORMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Family Medicine CurrentSince Feb 27, 2022 Accepting new patients
Ihc Health Services, Inc. CurrentSince Feb 27, 2022 Accepting new patients
Uptown Providers PC Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

2400 N Washington Blvd
Ogden, UT 84414
Phone (801) 387-8300

852 N 500 W
Provo, UT 84604
Phone (801) 357-4417

389 S 900 E
Slc, UT 84102
Phone (385) 282-2000

4401 Harrison Blvd
South Ogden, UT 84403
Phone (801) 387-2800

Organizations & group practices 5

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1003898149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-786-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N WASHINGTON BLVD",
            "city": "NORTH OGDEN",
            "state": "UT",
            "postal_code": "844147233",
            "telephone_number": "801-786-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POHLMAN",
        "first_name": "KIMBERLY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "12422287-1206",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "152511",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "Q53565",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Ogden, UT

Sources for this page

Verify at the official NPI Registry.