Kelton W Lundsberg, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

1699911205 Issued in UT

Practice address

1955 E 5600 S
Salt Lake City, UT 84121-1372

Phone

(801) 273-5000

NPI assigned

Aug 12, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192838400000",
    "number": "1386656221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-273-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 E 5600 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841211372",
            "telephone_number": "801-273-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDSBERG",
        "first_name": "KELTON",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "1699911205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Katherine Lundgren, OTR/L
• Lindsey Marguerite Lundholm
• Karl Kristian Lundin
• Grace Griffin Lundquist
• Stephen Nicholas Lundquist, OD
• Lauren Lundstrom, MOT, OTR/L
• Carol L. Lundwall, CPCI
• Ting Lung, L.AC
• Rebecca Lunn, DPT
• Peter Lunoe, MD

• Internal Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Internal Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.