Individual provider Active NPI

Melanie Che Kammerman, PA-C

  • Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1578814505
Registry record updated Jan 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8428681-1206 Issued in UT
Practice address
2390 S Redwood Rd
Salt Lake City, UT 84119-2027
Phone
(801) 975-1600
Fax
(801) 978-2693
NPI assigned
Oct 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8428681-1206 UT Primary

Addresses

Primary practice location

2390 S Redwood Rd
Salt Lake City, UT 84119-2027

Mailing address

2390 S Redwood Rd
Salt Lake City, UT 84119-2027
Phone (801) 975-1600

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
I20170213002351 UT Practitioner - Physician Assistant 2062795214 Reassigns benefits to 1 organization

National Provider Directory

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

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1578814505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2390 S REDWOOD RD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841192027",
            "telephone_number": "801-975-1600",
            "fax_number": "801-978-2693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2390 S REDWOOD RD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841192027",
            "telephone_number": "801-975-1600",
            "fax_number": "801-978-2693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMMERMAN",
        "first_name": "MELANIE",
        "middle_name": "CHE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-01",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8428681-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.