NPIMap

Individual provider Active NPI

Kimberly Zumwalt, RPH

  • Pharmacist
  • South Jordan, UT
National Provider Identifier
1770124638
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
377990-1701 Issued in UT
Practice address
1634 W South Jordan Pkwy
South Jordan, UT 84095-4562
Phone
(801) 254-4660
Fax
(801) 253-2561
NPI assigned
Oct 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 377990-1701 UT Primary

Addresses

Primary practice location

1634 W South Jordan Pkwy
South Jordan, UT 84095-4562

Mailing address

1634 W South Jordan Pkwy
South Jordan, UT 84095-4562
Phone (801) 254-4660

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL BirthControl 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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
377990-1701UTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Smiths Food & Drug Centers Inc PastSince Oct 6, 2019 Accepting new patients
Smith's Food & Drug Centers Inc PastSince Oct 6, 2019 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1770124638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 W SOUTH JORDAN PKWY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954562",
            "telephone_number": "801-254-4660",
            "fax_number": "801-253-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 W SOUTH JORDAN PKWY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954562",
            "telephone_number": "801-254-4660",
            "fax_number": "801-253-2561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUMWALT",
        "first_name": "KIMBERLY",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-02",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "377990-1701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "BirthControl",
            "affiliation": "N",
            "endpointDescription": "BirthControl",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1634 W South Jordan Pkwy",
            "city": "South Jordan",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840954562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.

Verify at the official NPI Registry.