Individual provider Active NPI

David Lee Kay Belnap, PA

  • Physician Assistant
  • South Jordan, UT
National Provider Identifier
1760175426
Registry record updated Oct 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14316262-1206 Issued in UT
Practice address
11444 S Redwood Rd
South Jordan, UT 84095-7803
Phone
(801) 253-5900
NPI assigned
May 30, 2023
Last updated
Oct 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 14316262-1206 UT Primary

Addresses

Primary practice location

11444 S Redwood Rd
South Jordan, UT 84095-7803

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

1107 W Poplar Ave
Porterville, CA 93257-5839
Phone (877) 960-3426

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io.8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240228003064 CA Practitioner - Physician Assistant 2062857154 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63091CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthcare Network CurrentSince Jan 15, 2024 Accepting new patients
Family Healthcare Network CurrentSince Jan 15, 2024 Accepting new patients
Family Healthcare Network Past Accepting new patients

Locations

1107 W Poplar Ave
Porterville, CA 93257
Phone (559) 781-7242

305 E Center Ave
Visalia, CA 93291
Phone (559) 737-4792

Organizations & group practices 4

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": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792368000000",
    "number": "1760175426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11444 S REDWOOD RD",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840957803",
            "telephone_number": "801-253-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1107 W Poplar Ave",
            "address_purpose": "LOCATION",
            "city": "Porterville",
            "state": "CA",
            "postal_code": "932575839",
            "country_code": "US",
            "telephone_number": "877-960-3426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELNAP",
        "first_name": "DAVID",
        "middle_name": "LEE KAY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-30",
        "last_updated": "2026-10-19",
        "certification_date": "2026-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "14316262-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io.8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

Verify at the official NPI Registry.