Active NPI
Katherine Ann Mailey, M.D.
- Pediatrics Physician
- Salt Lake City, UT
National Provider Identifier
1740712983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 10964195-1205
- Practice address
- 81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125 - Phone
- (801) 662-5700
- NPI assigned
- Mar 28, 2017
- Last updated
- Oct 21, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 10964195-1205 | UT | Primary |
Addresses
Primary practice location
81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125
Mailing address
81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125
Phone (801) 581-2121
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181102000687 | UT | Order and Referring Only - Pediatric Medicine | 7719230051 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10964195-1205 | UT | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osu Center for Health Sciences | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540080000000",
"number": "1740712983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "81 N MARIO CAPECCHI DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131125",
"telephone_number": "801-581-2121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "81 N MARIO CAPECCHI DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131125",
"telephone_number": "801-662-5700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAILEY",
"first_name": "KATHERINE",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-03-28",
"last_updated": "2018-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "UT",
"license": "10964195-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.