Active NPI
Kallie Kay Madsen
- Children's Substance Abuse Rehabilitation Facility
- Ephraim, UT
National Provider Identifier
1649930801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Children's Substance Abuse Rehabilitation Facility
- Practice address
- 66 N 180 W
Ephraim, UT 84627-2130 - Phone
- (435) 283-0164
- NPI assigned
- Dec 29, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Children's Substance Abuse Rehabilitation Facility | 3245S0500X | UT | Primary |
Addresses
Primary practice location
66 N 180 W
Ephraim, UT 84627-2130
Mailing address
66 N 180 W
Ephraim, UT 84627-2130
Phone (435) 283-0164
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Young Women'S Empowerment Center Long Term 3 | Past | Accepting new patients |
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.
-
- Mental Illness Community Based Residential Treatment Facility
- Ephraim, UT
- NPI 1245548742
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1640736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640736000000",
"number": "1649930801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 N 180 W",
"city": "EPHRAIM",
"state": "UT",
"postal_code": "846272130",
"telephone_number": "435-283-0164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "66 N 180 W",
"city": "EPHRAIM",
"state": "UT",
"postal_code": "846272130",
"telephone_number": "435-283-0164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADSEN",
"first_name": "KALLIE",
"middle_name": "KAY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-29",
"last_updated": "2021-12-29",
"certification_date": "2021-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "3245S0500X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
"state": "UT",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ephraim, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.