Active NPI
Clayton Denning Killpack, MD
- Anesthesiology Physician
- Sandy, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 4979083-1205
- Practice address
- 9660 S 1300 E
Sandy, UT 84094-3762 - Phone
- (801) 993-9582
- Fax
- (801) 733-5618
- NPI assigned
- Sep 1, 2006
- Last updated
- Sep 8, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 4979083-1205 | UT | Primary |
| Anesthesiology Physician | 207L00000X | 115334 | MT |
Addresses
Primary practice location
9660 S 1300 E
Sandy, UT 84094-3762
Mailing address
2975 Executive Pkwy
200
Lehi, UT 84043-9642
Phone (801) 990-1911
Other practice location 1
1101 26th St S
Great Falls, MT 59405-5161
Phone (406) 731-8888
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 107027653101 | Other | UT | IHC |
| 2090168 | Other | UT | UNITED HEALTHCARE |
| 77516 | Other | UT | PEHP |
| 826031 | Other | UT | HEALTHY U |
| 49790831200001 | Other | UT | BCBS |
| 806874300 | Medicaid | ID | |
| 850808 | Other | UT | DESERET MUTUAL |
| 870545614KIL | Other | UT | EDUCATORS MUTUAL |
| 100503296 | Medicaid | NV | |
| 119676600 | Medicaid | WY | |
| 1502954 | Other | UT | UMWA |
| 859647 | Medicaid | AZ | |
| QM0000075886 | Other | UT | ALTIUS |
| TPRA09320 | Other | UT | MOLINA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT, MT, OR, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1101 26TH St S
Great Falls, MT 59405-5161
Phone (406) 455-5000
601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 275-2141
630 Medical Dr
Bountiful, UT 84010-4908
Phone (801) 299-2160
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115334 | MT | MD | Anesthesiology Physician |
| 4979083-1205 | UT | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Anesthesia Associates LLC | Anesthesiology | Current | Accepting new patients |
| Mountain West Anesthesia LLC | Anesthesiology | Current | Accepting new patients |
| U of R Anesthesiology Group | Anesthesiology | Current | Accepting new patients |
| Benefis Hospitals Inc | Current | Accepting new patients | |
| Columbia Anesthesia Group P S | Anesthesiology | Current | Accepting new patients |
| Benefis Hospitals, Inc. | Current | Accepting new patients |
Locations
1101 26th St S
Great Falls, MT 59405
Phone (406) 455-4690
1101 26th St S
Fl 5
Great Falls, MT 59405
Phone (406) 455-2132
1401 25th St S
Great Falls, MT 59405
Phone (406) 455-3650
601 Elmwood Ave
#604
Rochester, NY 14642
Phone (585) 275-2141
1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582
7300 SW Childs Rd
Ste A
Tigard, OR 97224
Phone (360) 828-5396
630 Medical Dr
North Salt Lake, UT 84010
Phone (801) 292-6231
150 W Civic Center Dr
Ste 200
Sandy, UT 84070
Phone (801) 727-2056
9660 S 1300 E
Sandy, UT 84094
Phone (801) 314-2417
1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992
1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355
505 NE 87th Ave
Ste 210
Vancouver, WA 98664
Phone (360) 828-5396
Organizations & group practices 6
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.
-
- Anesthesiology Physician
- Bountiful, UT
- NPI 1174566277
-
dba Benefis Medical Group
- Multi-Specialty Clinic/Center
- Great Falls, MT
- NPI 1780968974
-
- Anesthesiology Physician
- Rochester, NY
- NPI 1609806488
-
- Anesthesiology Physician
- Lehi, UT
- NPI 1558391763
-
- General Acute Care Hospital
- Great Falls, MT
- NPI 1881650737
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Lakeview Hospital
- General Acute Care Hospital
- Bountiful, UT
- NPI 1528010451
-
dba Benefis Medical Group
- Multi-Specialty Clinic/Center
- Great Falls, MT
- NPI 1780968974
Hospital
-
- General Acute Care Hospital
- Great Falls, MT
- NPI 1881650737
-
- General Acute Care Hospital
- Rochester, NY
- NPI 1972548568
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662595200000",
"number": "1528160769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2975 EXECUTIVE PKWY",
"address_2": "200",
"city": "LEHI",
"state": "UT",
"postal_code": "840439642",
"telephone_number": "801-990-1911",
"fax_number": "801-990-1912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9660 S 1300 E",
"city": "SANDY",
"state": "UT",
"postal_code": "840943762",
"telephone_number": "801-993-9582",
"fax_number": "801-733-5618"
}
],
"practiceLocations": [
{
"address_1": "1101 26th St S",
"address_purpose": "LOCATION",
"city": "Great Falls",
"state": "MT",
"postal_code": "594055161",
"country_code": "US",
"telephone_number": "406-731-8888",
"fax_number": "406-731-8318",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KILLPACK",
"first_name": "CLAYTON",
"middle_name": "DENNING",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-01",
"last_updated": "2022-09-08",
"certification_date": "2022-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "UT",
"license": "4979083-1205",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MT",
"license": "115334",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHC",
"identifier": "107027653101",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2090168",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PEHP",
"identifier": "77516",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHY U",
"identifier": "826031",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "49790831200001",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "806874300",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DESERET MUTUAL",
"identifier": "850808",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EDUCATORS MUTUAL",
"identifier": "870545614KIL",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100503296",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119676600",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UMWA",
"identifier": "1502954",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "859647",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALTIUS",
"identifier": "QM0000075886",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOLINA",
"identifier": "TPRA09320",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sandy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.