NPIMap

Organization Active NPI

Kenneth L Crump MD PC

Doing business as Lakeview Family Medicine

  • Family Medicine Physician
  • Orem, UT
National Provider Identifier
1053408450
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
942752821205 Issued in UT
Legal business name
KENNETH L CRUMP MD PC
Doing business as
Lakeview Family Medicine
Practice address
811 N 900 W
Orem, UT 84057-7701
Phone
(801) 434-7600
Fax
(801) 434-7604
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Authorized official

Name
Dr. Kenneth L Crump, M.D.NPI 1891719308
Title
Ceo
Phone
(801) 434-7600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 942752821205 UT Primary

Addresses

Primary practice location

811 N 900 W
Orem, UT 84057-7701

Mailing address

811 N. 900 W.
Orem, UT 84057
Phone (801) 434-7600

Other practice location 1

41 E 1140 N Ste C
Saratoga Springs, UT 84045-5467
Phone (801) 766-2121

Other names 1

  • Lakeview Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040213000373 UT Part B Supplier - Clinic/Group Practice 0840184388 Receives reassigned benefits from 2 practitioners
Practice locations: Orem, UT; Saratoga Springs, UT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D0970318Kenneth L Crump MD, PC811 North 900 West, Orem, UT 84057Certificate of waiverDec 5, 2026
46D0994772Kenneth L Crump, MD PC41 E 1140 N, Suite C, Saratoga Springs, UT 84045Certificate of waiverJan 3, 2028

National Provider Directory

National Provider Directory

Locations

811 N 900 W
Orem, UT 84057
Phone (801) 434-7600

3200 N Canyon Rd
Ste E
Provo, UT 84604
Phone (801) 229-1014

41 E 1140 N
Ste C
Saratoga Springs, UT 84045
Phone (801) 766-2121

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3391/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621555200000",
    "number": "1053408450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 N. 900 W.",
            "city": "OREM",
            "state": "UT",
            "postal_code": "84057",
            "telephone_number": "801-434-7600",
            "fax_number": "801-434-7604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 N 900 W",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840577701",
            "telephone_number": "801-434-7600",
            "fax_number": "801-434-7604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 E 1140 N Ste C",
            "address_purpose": "LOCATION",
            "city": "Saratoga Springs",
            "state": "UT",
            "postal_code": "840455467",
            "country_code": "US",
            "telephone_number": "801-766-2121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KENNETH L CRUMP MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A",
        "authorized_official_last_name": "CRUMP",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-434-7600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "942752821205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeview Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lakeview Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orem, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.