Kelly L Hamblin, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

333413-0501 Issued in UT

Practice address

3181 W 9000 S
West Jordan, UT 84088-5610

Phone

(801) 965-3600

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

California School of Podiatric Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Granger Medical Clinic PCGroup PAC ID 3476465691, 192 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.hamblin@gmcwv.eclinicaldirectplus.com

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.

• Granger Medical Clinic PC

  • Multi-Specialty Clinic/Center
  • West Valley City, UT
  • NPI 1184657041

  UT

  Medicare reassignment Care Compare group NPD
• Granger Medical Specialists LLC

  • Clinic/Center
  • West Valley City, UT
  • NPI 1376159368

  UT

  Medicare reassignment NPD
• Granger Medical Clinic PC

  • Multi-Specialty Clinic/Center
  • West Jordan, UT
  • NPI 1104857549
  Care Compare group
• Granger Medical Clinic PC

  • Medical Specialty Clinic/Center
  • Sandy, UT
  • NPI 1871320028
  Care Compare group
• Granger Medical Clinic PC

  • Multi-Specialty Clinic/Center
  • Tooele, UT
  • NPI 1073811733
  NPD
• Granger Medical Specialists, LLC

  • Multi-Specialty Clinic/Center
  • Salt Lake City, UT
  • NPI 1497441539
  NPD

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1770515926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 W 3500 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841193602",
            "telephone_number": "801-965-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 W 9000 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840885610",
            "telephone_number": "801-965-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2751 W 9000 S",
            "address_purpose": "LOCATION",
            "city": "West Jordan",
            "state": "UT",
            "postal_code": "84088",
            "country_code": "US",
            "telephone_number": "801-352-5900",
            "fax_number": "801-352-5914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMBLIN",
        "first_name": "KELLY",
        "middle_name": "L",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "UT",
            "license": "333413-0501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alec Hale
• Diarmid Ian Hall, DMD
• Samuel David Hall
• Shandria Hall
• Hallelujah Home Health LLC
• Deeqa Hamid
• Danielle Jo Hamilton
• Allison Marie Hammon
• Eric Hammon, L.P.C.
• Bree Sage Hammond

• All providers in West Jordan, UT
• Podiatrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.