NPIMap

Individual provider Active NPI

Bruce R. Kenwood, DO

  • Interventional Cardiology Physician
  • Murray, UT
National Provider Identifier
1144279019
Registry record updated Feb 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
6213815-1204 Issued in UT
Practice address
5979 Fashion Blvd
Murray, UT 84107-7364
Phone
(801) 263-2370
Fax
(801) 265-1200
NPI assigned
May 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 6213815-1204 UT Primary
Cardiovascular Disease Physician 207RC0000X 6213815-1204 UT

Addresses

Primary practice location

5979 Fashion Blvd
Murray, UT 84107-7364

Mailing address

5979 Fashion Blvd
Murray, UT 84107-7364
Phone (801) 263-2370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060808000586 UT Practitioner - Cardiovascular Disease (Cardiology) 2567465792 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

3000 N Triumph Blvd
Lehi, UT 84043-7186

3336 S 4155
West Valley City, UT 84120

3584 W 9000
Suite 304
West Jordan, UT 84088-4775
Phone (801) 263-2370

82 S 1100
Suite 103
Salt Lake City, UT 84102-1889
Phone (801) 505-5370

913 W Baxter Dr
Suite 200
South Jordan, UT 84095-8687
Phone (801) 903-5688

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6213815-1204UTMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince May 1, 2023 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince May 1, 2023 Accepting new patients
Physician Group of Utah Inc CurrentSince Aug 20, 2019 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
Physician Group of Utah Inc Cardiovascular Disease Past Accepting new patients

Locations

5979 S Fashion Blvd
Salt Lake Cty, UT 84107
Phone (801) 263-0140

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

82 S 1100 E
Ste 103
Salt Lake Cty, UT 84102
Phone (801) 505-5370

2530 W 4700 S
Ste B8
Taylorsville, UT 84129
Phone (801) 967-5866

3584 W 9000 S
Ste 304
West Jordan, UT 84088
Phone (801) 568-3150

3570 W 9000 S
Ste 110
West Jordan, UT 84088
Phone (208) 201-1249

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

3336 S Pioneer Pkwy
Ste 203
West Valley City, UT 84120
Phone (801) 290-7153

196 Arrowhead Dr
Ste 5
Evanston, WY 82930
Phone (307) 783-8364

Networks

  • UT PPO D-SNP
  • UT PPO

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266796800000",
    "number": "1144279019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5979 FASHION BLVD",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077364",
            "telephone_number": "801-263-2370",
            "fax_number": "801-265-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5979 FASHION BLVD",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077364",
            "telephone_number": "801-263-2370",
            "fax_number": "801-265-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENWOOD",
        "first_name": "BRUCE",
        "middle_name": "R.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2010-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "UT",
            "license": "6213815-1204",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "UT",
            "license": "6213815-1204",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.