NPIMap

Organization Active NPI

Kelly a Gomez DPM PC

Doing business as Rocky Mountain Foot and Ankle

  • Podiatric Clinic/Center
  • Provo, UT
National Provider Identifier
1306092812
Registry record updated Jul 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
License
367951 Issued in UT
Legal business name
KELLY A GOMEZ DPM PC
Doing business as
Rocky Mountain Foot and Ankle
Practice address
777 N 500 W
Suite 105
Provo, UT 84601-1541
Phone
(801) 375-6677
NPI assigned
Aug 15, 2008
Last updated
Jul 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2009

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

Authorized official

Name
Kelly Allan Gomez, DPMNPI 1821021957
Title
Owner/President
Phone
(801) 375-6677

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X 367951 UT Primary

Addresses

Primary practice location

777 N 500 W
Suite 105
Provo, UT 84601-1541

Mailing address

777 N 500 W
Suite 105
Provo, UT 84601-1541
Phone (801) 375-6677

Other names 1

  • Rocky Mountain Foot and Ankle Doing business as

National Provider Directory

National Provider Directory

Locations

777 N 500 W
Ste 105
Provo, UT 84601
Phone (801) 373-1108

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246492800000",
    "number": "1306092812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 N 500 W",
            "address_2": "SUITE 105",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011541",
            "telephone_number": "801-375-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 N 500 W",
            "address_2": "SUITE 105",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011541",
            "telephone_number": "801-375-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY A GOMEZ DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-15",
        "last_updated": "2009-07-02",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "801-375-6677",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "UT",
            "license": "367951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rocky Mountain Foot and Ankle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.