Individual provider Active NPI

Kristina D Esham, MD

  • Pediatrics Physician
  • Riverton, UT
National Provider Identifier
1164533071
Registry record updated Nov 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
51135341205 Issued in UT
Practice address
3723 W 12600 S
Suite 450
Riverton, UT 84065-7295
Phone
(801) 285-4543
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 51135341205 UT Primary

Addresses

Primary practice location

3723 W 12600 S
Suite 450
Riverton, UT 84065-7295

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 285-4543

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060114000040 UT Practitioner - Pediatric Medicine 3375567506 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51135341205UTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Nov 19, 2014 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Pediatrics CurrentSince Nov 19, 2014 Accepting new patients
Ihc Health Services Inc Past Accepting new patients
Ihc Health Services Inc Pediatrics Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

3723 W 12600 S
Ste 330
Riverton, UT 84065
Phone (801) 285-4543

3723 W 12600 S
Ste 450
Riverton, UT 84065
Phone (801) 285-4540

3845 W 4700 S
West Valley City, UT 84129
Phone (801) 840-2020

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257724800000",
    "number": "1164533071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-285-4543",
            "fax_number": "801-285-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3723 W 12600 S",
            "address_2": "SUITE 450",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657295",
            "telephone_number": "801-285-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESHAM",
        "first_name": "KRISTINA",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "51135341205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, UT

Sources for this page

Verify at the official NPI Registry.