Individual provider Active NPI

Kurt R Umbrell, PA-C

  • Medical Physician Assistant
  • Layton, UT
National Provider Identifier
1417267956
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4935435-1206 Issued in UT
Practice address
2132 N 1700 W
Suite 200
Layton, UT 84041-7057
Phone
(801) 776-0174
Fax
(801) 825-3904
NPI assigned
Oct 18, 2010
Last updated
Apr 5, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4935435-1206 UT Primary

Addresses

Primary practice location

2132 N 1700 W
Suite 200
Layton, UT 84041-7057

Mailing address

PO Box 30180
Suite 310
Salt Lake City, UT 84130-0180
Phone (801) 362-0295

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
I20200512001572 UT Practitioner - Physician Assistant 6002114758 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1100 S Medical Dr
Mount Pleasant, UT 84647-2222
Phone (435) 462-4169

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Ihc Health Services Inc CurrentSince Mar 1, 2020 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Utah Cardiology PC PastSince Aug 1, 2012 Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

1100 S Medical Dr
Mt Pleasant, UT 84647
Phone (435) 462-2441

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1417267956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30180",
            "address_2": "SUITE 310",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300180",
            "telephone_number": "801-362-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2132 N 1700 W",
            "address_2": "SUITE 200",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840417057",
            "telephone_number": "801-776-0174",
            "fax_number": "801-825-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UMBRELL",
        "first_name": "KURT",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-18",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "4935435-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.