Individual provider Active NPI

K Michael Handlon, M.D.

  • Diagnostic Radiology Physician
  • Murray, UT
National Provider Identifier
1629077979
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
5120535-1205 Issued in UT
Practice address
5444 S. Green St.
Murray, UT 84123-5632
Phone
(801) 262-8120
Fax
(801) 262-3897
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 5120535-1205 UT Primary
Diagnostic Radiology Physician 2085R0202X M-11493 ID

Addresses

Primary practice location

5444 S. Green St.
Murray, UT 84123-5632

Mailing address

5444 S. Green St.
Murray, UT 84123-5632
Phone (801) 262-8120

Other identifiers 7

IdentifierTypeStateIssuer
100505538MedicaidNV
807115700MedicaidID
923632MedicaidAZ
P00651531OtherUTRR MEDICARE
120743100MedicaidWY
D4482MedicaidUT
P00199614OtherUTRR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address k.michael.handlon1@direct.imail.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050112001058 UT Practitioner - Diagnostic Radiology 4385693720 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Florida College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1380 E Medical Ctr Dr
St George, UT 84790-2123
Phone (435) 251-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M-11493IDMDDiagnostic Radiology Physician
5120535-1205UTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Jan 1, 2017 Accepting new patients
Mountain Medical Physician Specialists PC Body Imaging CurrentSince May 20, 2011 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Tellica Imaging, LLC Diagnostic Radiology CurrentSince Nov 16, 2023 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jan 12, 2024 Accepting new patients
Tellica Imaging, LLC CurrentSince Feb 21, 2022 Accepting new patients
MMPS Murray Past Accepting new patients
New Schryver LLC Past Accepting new patients
Utah Imaging Centers LLC Past Accepting new patients
West Valley Imaging LLC Diagnostic Radiology Past Accepting new patients
Schryver Medical Sales and Marketing LLC Past Accepting new patients
Utah Imaging Associates Inc Diagnostic Radiology PastSince Jan 1, 2005 Accepting new patients
Central Utah Radiology, PC Diagnostic Radiology Past Accepting new patients

Locations

1501 Hiland Ave
Burley, ID 83318
Phone (208) 678-4444

5295 S Commerce Dr
Ste 550
Salt Lake City, UT 84107
Phone (801) 313-4110

5334 S Woodrow St
#100
Salt Lake City, UT 84107
Phone (801) 284-1702

5444 S Green St
Salt Lake City, UT 84123
Phone (801) 262-2647

5217 S State St
Salt Lake City, UT 84107
Phone (801) 313-4110

5217 S State St
Ste 200
Salt Lake City, UT 84107
Phone (208) 417-5100

5323 S Woodrow St
Salt Lake City, UT 84107
Phone (801) 261-8346

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

36 S Street St
Ste 2200
Salt Lake Cty, UT 84111
Phone (385) 622-0669

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 5

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1629077979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5444 S. GREEN ST.",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841235632",
            "telephone_number": "801-262-8120",
            "fax_number": "801-262-3897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5444 S. GREEN ST.",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841235632",
            "telephone_number": "801-262-8120",
            "fax_number": "801-262-3897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANDLON",
        "first_name": "K",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "5120535-1205",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M-11493",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100505538",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807115700",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "923632",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00651531",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120743100",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D4482",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00199614",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "k.michael.handlon1@direct.imail.org",
            "affiliation": "N",
            "address_1": "5444 S. Green St.",
            "city": "Murray",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841235632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.