KC Medical Enterprise PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

7430003-1205 Issued in UT

Legal business name

KC MEDICAL ENTERPRISE PLLC

Practice address

415 South Medical Dr Ste C201
Bountiful, UT 84010-4946

Phone

(801) 298-2332

Fax

(801) 298-5018

NPI assigned

May 11, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Cynthia Canga-Siao, MD

Title

President

Phone

(801) 992-3130

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356048000000",
    "number": "1396037206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 SOUTH MEDICAL DR STE C201",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104946",
            "telephone_number": "801-992-3130",
            "fax_number": "801-992-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 SOUTH MEDICAL DR STE C201",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104946",
            "telephone_number": "801-298-2332",
            "fax_number": "801-298-5018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KC MEDICAL ENTERPRISE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-11",
        "last_updated": "2012-12-21",
        "status": "A",
        "authorized_official_last_name": "CANGA-SIAO",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-992-3130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "7430003-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Craig Karren, DDS
• Katherine Karren
• Douglas Spence Kasteler, MD
• Abigail Jolley Kay, LCSW
• Valerie Kay
• Ramah James Keddington, DDS
• Hayden Keele
• Trever E Keele, DMD
• Kathleen Joyce Keeler, L.C.S.W.
• Marti Ann Keil, L.C.S.W.

• Internal Medicine Physician in Bountiful, UT
• Providers in Bountiful, 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 Dec 21, 2012; 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.