Organization Active NPI

Kimball Crofts MD LLC

Doing business as Aesthetica Plastic Surgery

  • Plastic Surgery Physician
  • Lindon, UT
National Provider Identifier
1548512858
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
KIMBALL CROFTS MD LLC
Doing business as
Aesthetica Plastic Surgery
Practice address
385 W 600 N
Lindon, UT 84042-1330
Phone
(801) 785-8825
Fax
(801) 785-8826
NPI assigned
Oct 10, 2012
Last updated
Jan 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Authorized official

Name
Kimball M Crofts, M.D.NPI 1437216306
Title
President
Phone
(801) 785-8825

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X Primary

Addresses

Primary practice location

385 W 600 N
Lindon, UT 84042-1330

Mailing address

385 W 600 N
Lindon, UT 84042-1330
Phone (801) 785-8825

Other names 1

  • Aesthetica Plastic Surgery Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121015000196 UT Part B Supplier - Clinic/Group Practice 9931127628 Receives reassigned benefits from 2 practitioners
Practice locations: Lindon, UT

National Provider Directory

National Provider Directory

Locations

385 W 600 N
Lindon, UT 84042
Phone (801) 785-8825

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1349827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1548512858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 W 600 N",
            "city": "LINDON",
            "state": "UT",
            "postal_code": "840421330",
            "telephone_number": "801-785-8825",
            "fax_number": "801-785-8826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 W 600 N",
            "city": "LINDON",
            "state": "UT",
            "postal_code": "840421330",
            "telephone_number": "801-785-8825",
            "fax_number": "801-785-8826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBALL CROFTS MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-10",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "CROFTS",
        "authorized_official_first_name": "KIMBALL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-785-8825",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aesthetica Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lindon, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.