Individual provider Active NPI

Kellie Marie Herget

  • Community Health Worker
  • Midvale, UT
National Provider Identifier
1124338090
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
7575 S 900 E
Midvale, UT 84047-2343
Phone
(801) 208-1031
NPI assigned
Oct 13, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

7575 S 900 E
Midvale, UT 84047-2343

Mailing address

4525 S 1200 E
Salt Lake City, UT 84117-4154
Phone (801) 792-1622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1124338090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 S 1200 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174154",
            "telephone_number": "801-792-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7575 S 900 E",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840472343",
            "telephone_number": "801-208-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERGET",
        "first_name": "KELLIE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-13",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midvale, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.