Active NPI
Kelly Perkins, PA
- Physician Assistant
- Salt Lake City, UT
National Provider Identifier
1689187627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 104183641206
- Practice address
- 470 E 3900 S Ste 200
Salt Lake City, UT 84107-2332 - Phone
- (801) 747-2800
- NPI assigned
- Nov 13, 2017
- Last updated
- Nov 11, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10418364-1206 | UT | |
| Physician Assistant | 363A00000X | 104183641206 | UT | Primary |
Addresses
Primary practice location
470 E 3900 S Ste 200
Salt Lake City, UT 84107-2332
Mailing address
1302 N 900 W
Orem, UT 84057-2900
Phone (801) 360-6247
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kperkins412667@direct.med.utah.edu | Direct | UNIVERSITY OF UTAH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104183641206 | UT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636588800000",
"number": "1689187627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1302 N 900 W",
"city": "OREM",
"state": "UT",
"postal_code": "840572900",
"telephone_number": "801-360-6247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "470 E 3900 S STE 200",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841072332",
"telephone_number": "801-747-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERKINS",
"first_name": "KELLY",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-13",
"last_updated": "2021-11-11",
"certification_date": "2021-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "10418364-1206",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "104183641206",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kperkins412667@direct.med.utah.edu",
"affiliation": "Y",
"affiliationName": "UNIVERSITY OF UTAH",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.