Individual provider Active NPI

Kyle D Hansen, PHARMD

  • Pharmacist
  • West Valley City, UT
National Provider Identifier
1497049134
Registry record updated May 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
6729880-1701 Issued in UT
Practice address
3555 W 3500 S
West Valley City, UT 84119-2539
Phone
(801) 963-6874
Fax
(801) 965-9953
NPI assigned
May 28, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 6729880-1701 UT Primary

Addresses

Primary practice location

3555 W 3500 S
West Valley City, UT 84119-2539

Mailing address

3555 W 3500 S
West Valley City, UT 84119-2539
Phone (801) 963-6874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
6729880-1701UTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1306540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306540800000",
    "number": "1497049134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 W 3500 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841192539",
            "telephone_number": "801-963-6874",
            "fax_number": "801-965-9953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 W 3500 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841192539",
            "telephone_number": "801-963-6874",
            "fax_number": "801-965-9953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "KYLE",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-28",
        "last_updated": "2011-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "6729880-1701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.