Individual provider Active NPI

Kayla Landis

  • School Social Worker
  • Provo, UT
National Provider Identifier
1164061198
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
Practice address
1726 Buckley LN
Provo, UT 84606-5031
Phone
(801) 373-6562
NPI assigned
Dec 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X Primary

Addresses

Primary practice location

1726 Buckley LN
Provo, UT 84606-5031

Mailing address

1726 Buckley LN
Provo, UT 84606-5031
Phone (801) 373-6562

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": "1576800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1164061198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 BUCKLEY LN",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846065031",
            "telephone_number": "801-373-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 BUCKLEY LN",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846065031",
            "telephone_number": "801-373-6562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "KAYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-20",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "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 Dec 20, 2019; 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.