Individual provider Active NPI

Alec Kitch, M.D.

  • Family Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1104289487
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10495139-8905 Issued in UT
Practice address
1250 E 3900 S
Suite #260 BR
Salt Lake City, UT 84124-1348
Phone
(801) 265-2000
Fax
(801) 265-2008
NPI assigned
Apr 3, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10495139-8905 UT Primary

Addresses

Primary practice location

1250 E 3900 S
Suite #260 BR
Salt Lake City, UT 84124-1348

Mailing address

2308 S Wellington St
Salt Lake City, UT 84106-4121
Phone (843) 864-3808

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190815001997 UT Practitioner - Family Practice 0446544621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Carolina School of Medicine, 2016
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)

777 N Main St
Tooele, UT 84074-1611
Phone (435) 228-1200

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10495139-8905UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Aug 6, 2019 Accepting new patients
Ihc Health Services Inc CurrentSince Aug 6, 2019 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Utah Healthcare Institute Inc Family Medicine PastSince Jul 1, 2000 Accepting new patients

Locations

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

9450 S 1300 E
Sandy, UT 84094
Phone (801) 501-2133

777 N Main St
Tooele, UT 84074
Phone (435) 228-1200

Organizations & group practices 4

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": "1459641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1104289487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 S WELLINGTON ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841064121",
            "telephone_number": "843-864-3808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S",
            "address_2": "SUITE #260 BR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241348",
            "telephone_number": "801-265-2000",
            "fax_number": "801-265-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITCH",
        "first_name": "ALEC",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-03",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "10495139-8905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.