Active NPI
Kimberly Passmore
- Registered Dietitian
- Orem, UT
National Provider Identifier
1164598934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 58811134901
- Practice address
- 1790 N State Street
Orem, UT 84057-8255 - Phone
- (801) 224-8255
- Fax
- (801) 224-8301
- NPI assigned
- Nov 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 58811134901 | UT | Primary |
Addresses
Primary practice location
1790 N State Street
Orem, UT 84057-8255
Mailing address
1790 N State Street
Orem, UT 84057-8255
Phone (801) 224-8255
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58811134901 | UT | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164598934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1790 N STATE STREET",
"city": "OREM",
"state": "UT",
"postal_code": "840578255",
"telephone_number": "801-224-8255",
"fax_number": "801-224-8301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1790 N STATE STREET",
"city": "OREM",
"state": "UT",
"postal_code": "840578255",
"telephone_number": "801-224-8255",
"fax_number": "801-224-8301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASSMORE",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "UT",
"license": "58811134901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orem, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.