Patti Kiyomi Iwamoto, M.S., CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

1132224101 Issued in UT

Practice address

9071 South1300 West
Suite 100
West Jordan, UT 84088

Phone

(866) 581-9462

NPI assigned

Apr 2, 2007

Last updated

Aug 14, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• P.K. Iwamoto Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Audiology Associates of Salt Lake City, Inc.

  • Audiologist
  • South Jordan, UT
  • NPI 1407979479
  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439510400000",
    "number": "1700907557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 520223",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841520223",
            "telephone_number": "866-581-9462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9071 SOUTH1300 WEST",
            "address_2": "SUITE 100",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "84088",
            "telephone_number": "866-581-9462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWAMOTO",
        "first_name": "PATTI",
        "middle_name": "KIYOMI",
        "credential": "M.S., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2015-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "UT",
            "license": "1132224101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "P.K.",
            "last_name": "IWAMOTO",
            "credential": "M.S., CCC-A",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Intermountain Family Dental Care
• Intermountain Healthcare
• Ashlee Isbell
• Tayler Jane Iversen, LCSW
• Shelby Ivory
• J & J Business Ventures, LLC
• Jeffery B. Jackson, M.D.
• Nissa Marie Jackson
• Celena Jacques
• Tanya Jadrich

• Audiologist in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Audiologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.