Individual provider Active NPI

Kenji Kihara Hammon, CSW

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1659902872
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11599102-3501 Issued in UT
Practice address
660 S 200 E Ste 302
Salt Lake City, UT 84111-3846
Phone
(541) 287-0795
NPI assigned
Jan 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11599102-3501 UT Primary

Addresses

Primary practice location

660 S 200 E Ste 302
Salt Lake City, UT 84111-3846

Mailing address

5 S 500 W Unit 1204
Salt Lake City, UT 84101-4127
Phone (541) 287-0795

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230313001657 UT Practitioner - Clinical Social Worker 8426422551 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6778 S 700
Midvale, UT 84047-1359
Phone (801) 845-3442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11599102-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
ZHC Utah LLC CurrentSince Aug 15, 2023 Accepting new patients
BMSC Az LLC Clinical CurrentSince Feb 9, 2023 Accepting new patients
Ridgeline Counseling CurrentSince Sep 22, 2023 Accepting new patients

Locations

10204 Bode St
Ste C
Plainfield, IL 60585
Phone (630) 844-7077

310 E 4500 S
Ste 650
Salt Lake City, UT 84107
Phone (385) 378-7100

Organizations & group practices 3

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": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1659902872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 S 500 W UNIT 1204",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841014127",
            "telephone_number": "541-287-0795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 S 200 E STE 302",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841113846",
            "telephone_number": "541-287-0795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMON",
        "first_name": "KENJI",
        "middle_name": "KIHARA",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-27",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "11599102-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.