Individual provider Active NPI

Kyle M Turner, PA-C

  • Physician Assistant
  • Riverton, UT
National Provider Identifier
1730848631
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13006847-1206 Issued in UT
Practice address
12391 S 4000 W
Riverton, UT 84096-7012
Phone
(801) 302-1700
NPI assigned
Dec 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 13006847-1206 UT Primary
Physician Assistant 363A00000X

Addresses

Primary practice location

12391 S 4000 W
Riverton, UT 84096-7012

Mailing address

7181 S Campus View Dr Ste 200
West Jordan, UT 84084-4312
Phone (801) 965-3600

Other practice location 1

206 2nd St E
Bradenton, FL 34208-1042
Phone (941) 746-5111

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230105000428 UT Practitioner - Physician Assistant 3577943992 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
13006847-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Granger Medical Specialists, LLC CurrentSince Oct 11, 2023 Accepting new patients
True North Health Navigation LLC CurrentSince Jul 3, 2024 Accepting new patients
Granger Medical Clinic PC CurrentSince Jan 15, 2024 Accepting new patients
Granger Medical Clinic PC CurrentSince Jan 15, 2024 Accepting new patients

Locations

5187 S Ascension Way
Ste 175
Murray, UT 84123

12391 S 4000 W
Riverton, UT 84096
Phone (801) 302-1700

995 W Levoy Dr
Taylorsville, UT 84123

7181 S Campus View Dr
Ste 200
West Jordan, UT 84084
Phone (801) 965-3505

3725 W 4100 S
West Valley City, UT 84120
Phone (801) 965-3545

Interoperability endpoints

  • Direct secure messaging: kyle.turner.1@13869.direct.athenahealth.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1730848631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7181 S CAMPUS VIEW DR STE 200",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840844312",
            "telephone_number": "801-965-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12391 S 4000 W",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840967012",
            "telephone_number": "801-302-1700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "206 2nd St E",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342081042",
            "country_code": "US",
            "telephone_number": "941-746-5111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TURNER",
        "first_name": "KYLE",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-08",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "13006847-1206",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, UT

Sources for this page

Verify at the official NPI Registry.