Active NPI
Konrad Spencer Kennington, M.D.
- Anesthesiology Physician
- Provo, UT
National Provider Identifier
1114283371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 8771575-1205
- Practice address
- 1034 N 500 W
Provo, UT 84604 - Phone
- (801) 357-7850
- NPI assigned
- Apr 2, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 8771575-1205 | UT | |
| Anesthesiology Physician | 207L00000X | 8771575-1205 | UT | Primary |
Addresses
Primary practice location
1034 N 500 W
Provo, UT 84604
Mailing address
4308 N Chestnut Oak Dr
Lehi, UT 84043-4985
Phone (801) 821-7899
Other practice location 1
15 S 1000 E Ste 225
Payson, UT 84651-5593
Phone (801) 609-9310
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160517001943 | UT | Practitioner - Anesthesiology | 8325270010 | Reassigns benefits to 3 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- University of Utah School of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mountain West Anesthesia LLC
Practice addresses (Care Compare)
1034 N 500
Provo, UT 84604-3380
Phone (801) 357-7850
Hospital & facility affiliations
- Intermountain Health Utah Valley Hospital
- Intermountain Health Spanish Fork Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.53 of 100
- Quality
- 89.3
- Improvement activities
- 40
- Cost
- 78.06
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8771575-1205 | UT | MD | Pain Medicine (Anesthesiology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountain West Anesthesia LLC | Anesthesiology | Current | Accepting new patients |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Rock Creek Neurosurgery, LLC | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients |
Locations
3340 N Center St
Ste 800
Lehi, UT 84043
Phone (800) 501-4788
15 S 1000 E
Ste 225
Payson, UT 84651
Phone (801) 465-2511
1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119
150 W Civic Center Dr
Ste 200
Sandy, UT 84070
Phone (801) 727-2056
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992
1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1845
- konrad@rcn.gwaydirect.com
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.
-
- Multi-Specialty Clinic/Center
- Provo, UT
- NPI 1669422101
-
- Psychiatry Physician
- St George, UT
- NPI 1023843844
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559001600000",
"number": "1114283371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4308 N CHESTNUT OAK DR",
"city": "LEHI",
"state": "UT",
"postal_code": "840434985",
"telephone_number": "801-821-7899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1034 N 500 W",
"city": "PROVO",
"state": "UT",
"postal_code": "84604",
"telephone_number": "801-357-7850"
}
],
"practiceLocations": [
{
"address_1": "15 S 1000 E Ste 225",
"address_purpose": "LOCATION",
"city": "Payson",
"state": "UT",
"postal_code": "846515593",
"country_code": "US",
"telephone_number": "801-609-9310",
"fax_number": "801-465-0901",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KENNINGTON",
"first_name": "KONRAD",
"middle_name": "SPENCER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-02",
"last_updated": "2019-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "UT",
"license": "8771575-1205",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "UT",
"license": "8771575-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.