Kyle Richard McKeown, MD, MPH

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

13867707-1205 Issued in UT

Practice address

81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125

Phone

(702) 813-7858

NPI assigned

May 30, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Pediatric Medicine

Education

University of Arizona College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Utah Pediatric ServicesGroup PAC ID 0547552473, 129 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• University of Utah Pediatric Services

  • Pediatrics Physician
  • Salt Lake City, UT
  • NPI 1487018974
  Medicare reassignment Care Compare group NPD
• University of Utah Pediatric Services

  • Pediatric Infectious Diseases Physician
  • Salt Lake City, UT
  • NPI 1285098855
  NPD
• University of Utah Pediatric Services

  • Clinical Genetics (M.D.) Physician
  • Salt Lake City, UT
  • NPI 1861856619
  NPD
• University of Utah Pediatric Services

  • Pediatrics Physician
  • Riverton, UT
  • NPI 1043671985
  NPD (past)

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1669964334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4287 E RIVER FALLS DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857126650",
            "telephone_number": "702-813-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 N MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131125",
            "telephone_number": "702-813-7858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEOWN",
        "first_name": "KYLE",
        "middle_name": "RICHARD",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-30",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "R77002",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "UT",
            "license": "13867707-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah J McKenzie
• Shonte Zenequa McKenzie, M.D.
• Stacy Ann McKenzie, LPC
• Eric McKeon, PHARMD
• Hailey Michelle McKeon, SOCIAL WORKER
• Sean Briant McKeown, D.D.S.
• Elaine McKibbin
• Jessica McKim
• Shannon B. McKim, DO
• Rodrick D McKinlay, MD

• Pediatric Gastroenterology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Pediatric Gastroenterology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.