Active NPI
Alec Kitch, M.D.
- Family Medicine Physician
- Salt Lake City, UT
National Provider Identifier
1104289487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 10495139-8905
- 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
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 |
|---|---|---|---|---|
| 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
Enrollment records 1
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
Practice addresses (Care Compare)
777 N Main St
Tooele, UT 84074-1611
Phone (435) 228-1200
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10495139-8905 | UT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Utah Healthcare Institute Inc | Family Medicine | Past | 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.
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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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; 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.
- 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.