Active NPI
Keith Arthur Kirkham, MD
- Anesthesiology Physician
- Bountiful, UT
National Provider Identifier
1265444566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 157181-1205
- Practice address
- 630 Medical Dr
Bountiful, UT 84010-4908 - Phone
- (877) 594-2787
- NPI assigned
- Aug 13, 2006
- Last updated
- Oct 18, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 157181-1205 | UT | Primary |
Addresses
Primary practice location
630 Medical Dr
Bountiful, UT 84010-4908
Mailing address
630 Medical Dr
Bountiful, UT 84010-4908
Phone (877) 594-2787
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D1025 | Medicaid | UT |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 157181-1205 | UT | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192665600000",
"number": "1265444566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 MEDICAL DR",
"city": "BOUNTIFUL",
"state": "UT",
"postal_code": "840104908",
"telephone_number": "877-594-2787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 MEDICAL DR",
"city": "BOUNTIFUL",
"state": "UT",
"postal_code": "840104908",
"telephone_number": "877-594-2787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRKHAM",
"first_name": "KEITH",
"middle_name": "ARTHUR",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2007-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "UT",
"license": "157181-1205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D1025",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bountiful, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.