Kyleen Carpenter, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

8771462-1205 Issued in UT

Practice address

267 E Traversepoint Dr
Draper, UT 84020-5679

Phone

(801) 553-8300

Fax

(801) 553-8301

NPI assigned

Apr 12, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• South Summit Pediatrics. LLC

  • Legal Medicine
  • Draper, UT
  • NPI 1760490122
  NPD (past)
• Utah Imaging Associates Inc

  • Diagnostic Radiology Physician
  • Farmington, UT
  • NPI 1629076229
  NPD (past)

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1265799472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 E TRAVERSEPOINT DR",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840205679",
            "telephone_number": "801-553-8300",
            "fax_number": "801-553-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 E TRAVERSEPOINT DR",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840205679",
            "telephone_number": "801-553-8300",
            "fax_number": "801-553-8301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Mario Capecchi Dr",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841131103",
            "country_code": "US",
            "telephone_number": "801-662-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "KYLEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-12",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "8771462-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Care One Partners LLC
• Madison Armida Carl
• Avery Carling
• Christin Carlson, CD(DONA), CAD (MCU)
• Caroline Welsh LLC
• Chloe Carr
• Jaxson Carr
• Michele Holley Carr, RD, CD,DPM
• Kristen Danielle Carrier, PA-C
• Megan Lee Carroll, PT

• Pediatrics Physician in Draper, UT
• Providers in Draper, UT by specialty
• Pediatrics Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.