Individual provider Active NPI

Kavya Indira Rao, MD

  • Epilepsy Physician
  • Farr West, UT
National Provider Identifier
1164800496
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Epilepsy PhysicianTaxonomy code 2084E0001X
License
0101285535 Issued in VA
Practice address
2850 N 2000 W Ste 101
Farr West, UT 84404-9230
Phone
(801) 528-5095
Fax
(801) 528-5094
NPI assigned
May 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X A167664 CA
Epilepsy Physician 2084E0001X 0101285535 VA Primary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X MD70047599 WA
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 12474837-1205 UT
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2850 N 2000 W Ste 101
Farr West, UT 84404-9230

Mailing address

1055 N 500 W
Provo, UT 84604-3305
Phone (801) 354-8225

Other practice location 1

2211 NE 139th St
Vancouver, WA 98686-2742
Phone (360) 487-1000

Other practice location 2

1250 E Marshall St
Richmond, VA 23298-5023
Phone (804) 828-9350

Other practice location 3

1055 N 500 W
Attn Credentialing
Provo, UT 84604
Phone (801) 354-8225

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@reverehealth.com Direct Revere Health PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, IN, NM, WA, VA, OR6 enrollments
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 6

Enrollment IDStateProvider typePAC IDDetails
I20211208001531 UT Practitioner - NeurologyPractitioner - Psychiatry 1052701927 Reassigns benefits to 1 organization
I20250612003724 IN Practitioner - Neurology 1052701927 Reassigns benefits to 1 organization
I20251105001304 NM Practitioner - Neurology 1052701927 Reassigns benefits to 1 organization
I20251111003572 WA Practitioner - Neurology 1052701927 Reassigns benefits to 1 organization
I20251223002257 VA Practitioner - Neurology 1052701927 Reassigns benefits to 1 organization
I20260115002441 OR Practitioner - NeurologyPractitioner - Epileptologists 1052701927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

1250 E Marshall St
Richmond, VA 23219-5051
Phone (804) 828-9000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101285535VAMDEpilepsy Physician
A167664CAMDNeurology with Special Qualifications in Child Neurology Physician
MD70047599WAMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital, Inc. CurrentSince Jul 1, 2025 Accepting new patients
MCV Associated Physicians CurrentSince Oct 7, 2025 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Oct 29, 2025 Accepting new patients
Revere Health PC CurrentSince May 23, 2023 Accepting new patients
Cibola General Hospital Corporation CurrentSince Oct 7, 2025 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Oct 29, 2025 Accepting new patients
Union Hospital, Inc. CurrentSince Jul 1, 2025 Accepting new patients
Revere Health PC CurrentSince May 23, 2023 Accepting new patients
Legacy Clinics LLC CurrentSince Dec 7, 2025 Accepting new patients
Legacy Clinics LLC CurrentSince Dec 7, 2025 Accepting new patients

Locations

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

1423 E Roosevelt Ave
Grants, NM 87020
Phone (505) 287-6500

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

2850 N 2000 W
Ste 101
Ogden, UT 84404
Phone (801) 528-5095

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

1250 E Marshall St
Richmond, VA 23298
Phone (804) 628-6990

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Organizations & group practices 10

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 2

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": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1164800496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 N 2000 W STE 101",
            "city": "FARR WEST",
            "state": "UT",
            "postal_code": "844049230",
            "telephone_number": "801-528-5095",
            "fax_number": "801-528-5094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2211 NE 139th St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986862742",
            "country_code": "US",
            "telephone_number": "360-487-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 E Marshall St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985023",
            "country_code": "US",
            "telephone_number": "804-828-9350",
            "fax_number": "804-807-7949",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1055 N 500 W",
            "address_2": "Attn Credentialing",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "84604",
            "country_code": "US",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAO",
        "first_name": "KAVYA",
        "middle_name": "INDIRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "CA",
            "license": "A167664",
            "primary": false
        },
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "VA",
            "license": "0101285535",
            "primary": true
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "WA",
            "license": "MD70047599",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "UT",
            "license": "12474837-1205",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Revere Health PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1055 N 500 W",
            "address_2": "Attn Credentialing",
            "city": "Provo",
            "state": "UT",
            "country_code": "US",
            "postal_code": "84604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farr West, UT

Sources for this page

Verify at the official NPI Registry.