Gerald Kelty, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1972371206 Issued in UT

Practice address

2295 Foothill Dr
Salt Lake City, UT 84109-4000

Phone

(801) 486-3021

Fax

(801) 485-6339

NPI assigned

Jul 7, 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

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

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Foothill Clinic LLCGroup PAC ID 9931003795, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Medical Center Hospital, Murray, UT, CCN 460010
• St Mark'S Hospital Hospital, Salt Lake City, UT, CCN 460047
• LDS Hospital Hospital, Salt Lake City, UT, CCN 460006

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://epicproxy.et4001.epichosted.com/APIProxyPRD/FFC/api/FHIR/R4
• Direct secure messaging: gkelty23185@foothillfamilyclinic.gardenplot.direct-ci.com

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.

• Foothill Clinic, LLC

  dba Foothill Family Clinic

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1407947005
  Medicare reassignment Care Compare group
• Foothill Clinic, LLC

  dba Foothill Family Clinic

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1265513964
  NPD (past)

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

• Ihc Health Services, Inc.

  dba Intermountain Health Intermountain Medical Center

  • General Acute Care Hospital
  • Murray, UT
  • NPI 1043220650
  Care Compare affiliation
• Ihc Health Services, Inc.

  dba Intermountain Health LDS Hospital

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1528078581
  Care Compare affiliation
• Northern Utah Healthcare Corporation

  dba St. Mark'S Hospital

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1164469243
  Care Compare affiliation

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417989823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2295 FOOTHILL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841094000",
            "telephone_number": "801-486-3021",
            "fax_number": "801-485-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 FOOTHILL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841094000",
            "telephone_number": "801-486-3021",
            "fax_number": "801-485-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELTY",
        "first_name": "GERALD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "1972371206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Kelso
• Kelly Lee Kelso, CPNP
• Taylor Anne Kelso, BSN, RN
• Aria Lee Dorothy Kelson
• Bailey Eliana Bushell Kelson
• Jason Kemble
• Breann Kemp
• Brooklyn Kemper
• Charity Paaga Sallysului Kempton, BCBA, LBA
• Allison Kendall, NURSE PRACTITIONER

• Medical Physician Assistant in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Medical Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.