Individual provider Active NPI

Kendra Ann Parker

  • Surgical Physician Assistant
  • American Fork, UT
National Provider Identifier
1447209473
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
7047461-1206 Issued in UT
Practice address
1184 E 80 N
American Fork, UT 84003-2906
Phone
(801) 763-3885
Fax
(801) 763-3887
NPI assigned
May 8, 2006
Last updated
Aug 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 7047461-1206 UT Primary
Surgical Physician Assistant 363AS0400X 2005000370 MO

Addresses

Primary practice location

1184 E 80 N
American Fork, UT 84003-2906

Mailing address

1055 N 500 W
Credentialing Department
Provo, UT 84604-3305
Phone (801) 354-8225

Other practice location 1

3000 N Triumph Blvd Ste 100
Lehi, UT 84043-4999
Phone (801) 763-3885

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address medreview@reverehealth.com Central Utah Clinic, P.C.

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
I20081203000087 UT Practitioner - Physician Assistant 9830146992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Revere Health PCGroup PAC ID 7517868508, 407 clinicians

Practice addresses (Care Compare)

1184 E 80
American Fork, UT 84003-2906
Phone (801) 763-3885

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Sep 26, 2008 Accepting new patients
Revere Health PC CurrentSince Sep 26, 2008 Accepting new patients

Locations

1184 E 80 N
American Fork, UT 84003
Phone (801) 756-7777

3000 N Triumph Blvd
Ste 100
Lehi, UT 84043
Phone (385) 345-3155

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362

Interoperability endpoints

  • Direct secure messaging: kendraparker@cuccu.allscriptsdirect.net

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.

Hospital & facility affiliations 2

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1447209473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "address_2": "CREDENTIALING DEPARTMENT",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1184 E 80 N",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032906",
            "telephone_number": "801-763-3885",
            "fax_number": "801-763-3887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 N Triumph Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lehi",
            "state": "UT",
            "postal_code": "840434999",
            "country_code": "US",
            "telephone_number": "801-763-3885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKER",
        "first_name": "KENDRA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "UT",
            "license": "7047461-1206",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "2005000370",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Central Utah Clinic, P.C.",
            "address_1": "1184 E 80 N",
            "city": "American Fork",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840032906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

Verify at the official NPI Registry.