Individual provider Active NPI

Deborah Sue Keye, PAC PHYSICIAN ASSIST

  • Medical Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1164559159
Registry record updated May 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4821539-1206 Issued in UT
Practice address
4460 S Highland Dr
Ste 400
Salt Lake City, UT 84124-3543
Phone
(801) 272-4111
Fax
(801) 272-5989
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4821539-1206 UT Primary
Medical Physician Assistant 363AM0700X

Addresses

Primary practice location

4460 S Highland Dr
Ste 400
Salt Lake City, UT 84124-3543

Mailing address

4460 S Highland Dr
Ste 400
Salt Lake City, UT 84124-3543
Phone (801) 272-4111

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140623002809 UT Practitioner - Physician Assistant 0547484065 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlas Internal Medicine LLCGroup PAC ID 6608267455, 3 clinicians

Practice addresses (Care Compare)

6965 S Union Park Ctr
Suite 430
Cottonwood Heights, UT 84047-6507
Phone (385) 308-8937

Hospital & facility affiliations

  • Intermountain Health Alta View Hospital Hospital, Sandy, UT, CCN 460044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 2

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 1

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400803200000",
    "number": "1164559159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4460 S HIGHLAND DR",
            "address_2": "STE 400",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841243543",
            "telephone_number": "801-272-4111",
            "fax_number": "801-272-5989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4460 S HIGHLAND DR",
            "address_2": "STE 400",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841243543",
            "telephone_number": "801-272-4111",
            "fax_number": "801-272-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYE",
        "first_name": "DEBORAH",
        "middle_name": "SUE",
        "credential": "PAC PHYSICIAN ASSIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2014-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "4821539-1206",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.