Individual provider Active NPI

Kathleen R Deremer, MD

  • Hospitalist Physician
  • Ogden, UT
National Provider Identifier
1437267192
Registry record updated Sep 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
320722-1205 Issued in UT
Practice address
5405 S 500 E
Suite 100
Ogden, UT 84405-6957
Phone
(801) 475-8600
Fax
(801) 475-8686
NPI assigned
Aug 25, 2006
Last updated
Sep 9, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 320722-1205 UT
Hospitalist Physician 208M00000X 320722-1205 UT Primary

Addresses

Primary practice location

5405 S 500 E
Suite 100
Ogden, UT 84405-6957

Mailing address

5405 S 500 E
Suite 100
Ogden, UT 84405-6957
Phone (801) 475-8600

Other identifiers 1

IdentifierTypeStateIssuer
1437267192MedicaidUT

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070711000383 UT Practitioner - Internal Medicine 0345340980 Practice locations: Ogden, UT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
320722-1205UTMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Radiology Associates Past Accepting new patients
Hti Physician Services of Utah, Inc Past Accepting new patients

Organizations & group practices 2

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1437267192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 S 500 E",
            "address_2": "SUITE 100",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844056957",
            "telephone_number": "801-475-8600",
            "fax_number": "801-475-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 S 500 E",
            "address_2": "SUITE 100",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844056957",
            "telephone_number": "801-475-8600",
            "fax_number": "801-475-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEREMER",
        "first_name": "KATHLEEN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "320722-1205",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "UT",
            "license": "320722-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437267192",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.