Individual provider Active NPI

Rachel Anne Koll, M.D.

  • Pediatric Anesthesiology Physician
  • Salt Lake City, UT
National Provider Identifier
1740434224
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
7151932-1205 Issued in UT
Practice address
100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone
(801) 662-3577
Fax
(801) 662-3583
NPI assigned
Nov 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 7151932-1205 UT
Pediatric Anesthesiology Physician 207LP3000X 7151932-1205 UT Primary

Addresses

Primary practice location

100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103

Mailing address

PO Box 3870
Salt Lake City, UT 84110-3870
Phone (801) 662-3578

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140815002092 UT Practitioner - Anesthesiology 9133371099 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7151932-1205UTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Anesthesiologists Inc Anesthesiology CurrentSince Sep 1, 2014 Accepting new patients

Locations

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

Organizations & group practices 1

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": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1740434224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3870",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841103870",
            "telephone_number": "801-662-3578",
            "fax_number": "801-662-3583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-662-3577",
            "fax_number": "801-662-3583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLL",
        "first_name": "RACHEL",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-10",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "7151932-1205",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "UT",
            "license": "7151932-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.