Kyle James Eardley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

14193025-1206 Issued in UT

Practice address

383 S 300 E
St George, UT 84770-3620

Phone

(435) 628-2826

NPI assigned

Nov 25, 2024

Sex

Male

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Touro Un Col of Osteopathic Medicine, Henderson, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Skin and Cancer LLCGroup PAC ID 4587675004, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Southwest Skin and Cancer LLC

  • Specialist
  • St George, UT
  • NPI 1619929783
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1376369231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "383 S 300 E",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847703620",
            "telephone_number": "435-628-2826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "383 S 300 E",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847703620",
            "telephone_number": "435-628-2826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARDLEY",
        "first_name": "KYLE",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "14193025-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryce Eagar, DDS
• Michael Eagar
• Eagle Ranch Academy
• Eagle Ranch Academy
• Eagle Ranch Outpatient Services
• Mason Eardley
• Darren Boyd Earl, DMD
• Jacob Daniel Earl, OTR/L
• Martha Earl
• Michaela Earles

• Physician Assistant in St George, UT
• Providers in St George, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.