NPIMap

Individual provider Active NPI

Kavita G Willesen, MD

  • Internal Medicine Physician
  • Cottonwood Heights, UT
National Provider Identifier
1689684185
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50493791205 Issued in UT
Practice address
6965 S Union Park Ctr Ste 430
Cottonwood Heights, UT 84047-6507
Phone
(385) 308-8937
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 50493791205 UT Primary

Addresses

Primary practice location

6965 S Union Park Ctr Ste 430
Cottonwood Heights, UT 84047-6507

Mailing address

8165 S Willow Creek CV
Cottonwood Heights, UT 84093-6203
Phone (385) 308-8937

Other practice location 1

8165 S Willow Creek Cv
Cottonwood Heights, UT 84093-6203
Phone (385) 308-8937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220107000849 UT Practitioner - Internal Medicine 2961482971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rush Medical College of Rush University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlas Internal Medicine LLCGroup PAC ID 6608267455, 3 clinicians

Practice addresses (Care Compare)

6965 S Union Park Ctr
Suite 430
Cottonwood Heights, UT 84047-6507
Phone (385) 308-8937

Hospital & facility affiliations

  • Atlas Hospice Hospice, Layton, UT, CCN 461535
  • Intermountain Health Alta View Hospital Hospital, Sandy, UT, CCN 460044
  • LDS Hospital Hospital, Salt Lake City, UT, CCN 460006
  • Park City Hospital Hospital, Park City, UT, CCN 460057
  • University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009
  • Intermountain Medical Center Hospital, Murray, UT, CCN 460010

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50493791205UTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlas Internal Medicine LLC Internal Medicine CurrentSince Dec 20, 2021 Accepting new patients
Granger Medical Specialists LLC Past Accepting new patients

Locations

6965 S Union Park Ctr
Ste 430
Cottonwood Heights, UT 84047
Phone (385) 308-8937

9844 S 1300 E
Ste 125
Sandy, UT 84094
Phone (801) 501-8233

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IJDJBA
  • Direct secure messaging: atlasinternalmedicinekavitawillesen@151884.advancedmd-direct.com

Organizations & group practices 2

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.

Hospital & facility affiliations 8

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1689684185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8165 S WILLOW CREEK CV",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "840936203",
            "telephone_number": "385-308-8937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6965 S UNION PARK CTR STE 430",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "840476507",
            "telephone_number": "385-308-8937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8165 S Willow Creek Cv",
            "address_purpose": "LOCATION",
            "city": "Cottonwood Heights",
            "state": "UT",
            "postal_code": "840936203",
            "country_code": "US",
            "telephone_number": "385-308-8937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLESEN",
        "first_name": "KAVITA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "50493791205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood Heights, UT

Sources for this page

Verify at the official NPI Registry.