Individual provider Active NPI

Kylee Shumway, PHARMD

  • Pharmacist
  • North Salt Lake, UT
National Provider Identifier
1316452410
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
6372629-1701 Issued in UT
Practice address
160 Cutler Dr
North Salt Lake, UT 84054-2966
Phone
(853) 242-5083
NPI assigned
Dec 11, 2017
Last updated
Dec 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 6372629-8911 UT
Pharmacist 183500000X 6372629-1701 UT Primary

Addresses

Primary practice location

160 Cutler Dr
North Salt Lake, UT 84054-2966

Mailing address

669 W 900 N
North Salt Lake, UT 84054-2602
Phone (801) 294-1400

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
6372629-1701UTMDPharmacist
6372629-8911UTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Medquest Pharmacy Past Accepting new patients
Med Quest Pharmacy Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1316452410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 W 900 N",
            "city": "NORTH SALT LAKE",
            "state": "UT",
            "postal_code": "840542602",
            "telephone_number": "801-294-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 CUTLER DR",
            "city": "NORTH SALT LAKE",
            "state": "UT",
            "postal_code": "840542966",
            "telephone_number": "853-242-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMWAY",
        "first_name": "KYLEE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-11",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "6372629-8911",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "6372629-1701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Salt Lake, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.