Individual provider Active NPI

Kylie Meeshel Bair, LCSW

  • Clinical Social Worker
  • American Fork, UT
National Provider Identifier
1427408343
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7747014-3502 Issued in UT
Practice address
1062 E Bamberger Dr
American Fork, UT 84003-5504
Phone
(801) 642-2193
NPI assigned
Jun 21, 2016
Last updated
Jun 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7747014-3502 UT Primary

Addresses

Primary practice location

1062 E Bamberger Dr
American Fork, UT 84003-5504

Mailing address

1062 E Bamberger Dr
American Fork, UT 84003-5504
Phone (801) 642-2193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 27, 2023 through Nov 27, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7747014-3502UTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1427408343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1062 E BAMBERGER DR",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840035504",
            "telephone_number": "801-642-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1062 E BAMBERGER DR",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840035504",
            "telephone_number": "801-642-2193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIR",
        "first_name": "KYLIE",
        "middle_name": "MEESHEL",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "7747014-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

Verify at the official NPI Registry.