Individual provider Active NPI

Kathy Stretch Garcia, MD

  • Pediatrics Physician
  • South Jordan, UT
National Provider Identifier
1366767147
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4824557-1205 Issued in UT
Practice address
3556 W 9800 S Ste 101
South Jordan, UT 84095
Phone
(801) 567-9780
Fax
(801) 567-9826
NPI assigned
Apr 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4824557-1205 UT Primary

Addresses

Primary practice location

3556 W 9800 S Ste 101
South Jordan, UT 84095

Mailing address

3556 W 9800 S Ste 101
South Jordan, UT 84095-3221
Phone (801) 567-9780

Other names 1

  • Kathy Lynd Stretch Former name

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
I20140117001742 UT Practitioner - Pediatric Medicine 6709014822 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4824557-1205UTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Copperview Medical Center, LLC CurrentSince Oct 9, 2013 Accepting new patients

Locations

12842 S 3600 W
Ste 102
Riverton, UT 84065
Phone (801) 567-9780

3556 W 9800 S
Ste 101
South Jordan, UT 84095
Phone (801) 567-9780

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": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1366767147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3556 W 9800 S STE 101",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840953221",
            "telephone_number": "801-567-9780",
            "fax_number": "801-567-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3556 W 9800 S STE 101",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "84095",
            "telephone_number": "801-567-9780",
            "fax_number": "801-567-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "KATHY",
        "middle_name": "STRETCH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-05",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "4824557-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "STRETCH",
            "middle_name": "LYND",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Jordan, UT

Sources for this page

Verify at the official NPI Registry.