Individual provider Active NPI

Kirk M Gilmore, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Salt Lake City, UT
National Provider Identifier
1356361810
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
159628-1205 Issued in UT
Practice address
8TH Avenue C St
Salt Lake City, UT 84143-0001
Phone
(801) 269-2500
Fax
(801) 269-2690
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 159628-1205 UT Primary

Addresses

Primary practice location

8TH Avenue C St
Salt Lake City, UT 84143-0001

Mailing address

PO Box 30180
Salt Lake City, UT 84130-0180
Phone (801) 269-2500

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080729000096 UT Practitioner - Emergency Medicine 7618041468 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
159628-1205UTMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Emergency Physicians CurrentSince Nov 1, 2019 Accepting new patients

Locations

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

Interoperability endpoints

  • Direct secure messaging: kirk.gilmore.1@16501.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356361810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30180",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300180",
            "telephone_number": "801-269-2500",
            "fax_number": "801-269-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8TH AVENUE C ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841430001",
            "telephone_number": "801-269-2500",
            "fax_number": "801-269-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "KIRK",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "UT",
            "license": "159628-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.