Individual provider Active NPI

Kilee Danielle Robinson, PA-C

  • Physician Assistant
  • Clinton, UT
National Provider Identifier
1407368087
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10471619-1206 Issued in UT
Practice address
1477 N 2000 W
Clinton, UT 84015-8638
Phone
(801) 773-4840
Fax
(801) 525-8151
NPI assigned
Nov 3, 2017
Last updated
Aug 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10471619-1206 UT Primary
Family Medicine Physician 207Q00000X 10471619-1206 UT

Addresses

Primary practice location

1477 N 2000 W
Clinton, UT 84015-8638

Mailing address

PO Box 337
Layton, UT 84041-0337
Phone (801) 773-4840

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180124003511 UT Practitioner - Physician Assistant 8729347521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Memorial ClinicGroup PAC ID 4284547985, 251 clinicians

Practice addresses (Care Compare)

2121 N 1700
Layton, UT 84041-8803
Phone (801) 773-4840

425 S 100
Layton, UT 84041-5356
Phone (801) 773-4840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10471619-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Memorial Clinic CurrentSince Jan 1, 2019 Accepting new patients
Tanner Memorial Clinic Family Medicine CurrentSince Jan 1, 2019 Accepting new patients
Tanner Memorial Clinic Past Accepting new patients
Rosenberg Cooley Metcalf LC Past Accepting new patients
Radiology Associates of Albuquerque, PA Past Accepting new patients

Locations

1477 N 2000 W
Ste C
Clinton, UT 84015
Phone (801) 546-9441

444 W Bourne Cir
Farmington, UT 84025

444 W Bourne Cir
Ste 101
Farmington, UT 84025
Phone (801) 294-9333

425 S 100 W
Layton, UT 84041
Phone (801) 682-8708

2038 W 1900 S
Syracuse, UT 84075
Phone (801) 773-7899

Interoperability endpoints

  • Direct secure messaging: kilee.robinson.p1@direct.tannerclinic.nextgenshare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1407368087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 337",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840410337",
            "telephone_number": "801-773-4840",
            "fax_number": "801-525-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1477 N 2000 W",
            "city": "CLINTON",
            "state": "UT",
            "postal_code": "840158638",
            "telephone_number": "801-773-4840",
            "fax_number": "801-525-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "KILEE",
        "middle_name": "DANIELLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-03",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "10471619-1206",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "10471619-1206",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, UT

Sources for this page

Verify at the official NPI Registry.