Shane Merwin Kjar, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3757931206 Issued in UT

Practice address

324 10TH Ave Ste 154
Salt Lake City, UT 84103-2876

Phone

(801) 408-8666

Fax

(801) 322-0567

NPI assigned

Jul 13, 2006

Last updated

Feb 19, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Ihc Health Services Inc

  dba IMED Physicians Billing

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880
  Medicare reassignment
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment
• Ihc Health Services Inc

  dba Primary Children's Hospital Specialty Clinic Physicians Group

  • Pediatrics Physician
  • Salt Lake City, UT
  • NPI 1003255464
  NPD
• Ihc Health Services Inc

  dba Sandy Clinic

  • Internal Medicine Physician
  • Sandy, UT
  • NPI 1164558847
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1013932342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 10TH AVE STE 154",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032876",
            "telephone_number": "801-408-8666",
            "fax_number": "801-322-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 10TH AVE STE 154",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032876",
            "telephone_number": "801-408-8666",
            "fax_number": "801-322-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KJAR",
        "first_name": "SHANE",
        "middle_name": "MERWIN",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "3757931206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Celestial Kitiona
• Judith Ahrano Kittel, MD
• Hannah Kittleson
• Breanna Kathryn Kjar
• Joseph Kjar
• Carl R. Kjeldsberg, MD
• Helen Kjolby, PHD
• Kendra Alyse Klag, PHD
• Christie Ann Klangos
• Brent G. Klapthor, MD, MS

• Physician Assistant in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.

Verify at the official NPI Registry.