Active NPI
Allan L Havili
- Community Health Worker
- Erda, UT
National Provider Identifier
1720623994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 3023 N Bronzewood Cir
Erda, UT 84074-3302 - Phone
- (435) 255-7650
- NPI assigned
- Nov 12, 2019
- Last updated
- Dec 23, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
3023 N Bronzewood Cir
Erda, UT 84074-3302
Mailing address
9045 S 1300 E
Sandy, UT 84094-3134
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | KaleidaCare | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Utah Family Multi Care Services, LLC | Current | Accepting new patients | |
| Live for Life Cypress | Past | Accepting new patients |
Locations
9045 S 1300 E
Sandy, UT 84094
Phone (801) 666-6834
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Illness Community Based Residential Treatment Facility
- West Jordan, UT
- NPI 1295046100
-
- Mental Illness Community Based Residential Treatment Facility
- Erda, UT
- NPI 1922492057
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577059200000",
"number": "1720623994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9045 S 1300 E",
"city": "SANDY",
"state": "UT",
"postal_code": "840943134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3023 N BRONZEWOOD CIR",
"city": "ERDA",
"state": "UT",
"postal_code": "840743302",
"telephone_number": "435-255-7650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAVILI",
"first_name": "ALLAN",
"middle_name": "L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-11-12",
"last_updated": "2019-12-23",
"certification_date": "2019-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "KaleidaCare",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3023 N Bronzewood Cir",
"city": "Erda",
"state": "UT",
"country_code": "US",
"postal_code": "840743302",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Erda, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.