Kenneth A Zollo, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

3227931205 Issued in UT

Practice address

1675 N Freedom Blvd
BLDG 3
Provo, UT 84604-2540

Phone

(801) 377-8000

Fax

(801) 377-8001

NPI assigned

Apr 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Pediatric Care Inc

  • Pediatrics Physician
  • Provo, UT
  • NPI 1811956352
  NPD (past)

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318204800000",
    "number": "1770545931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 N FREEDOM BLVD",
            "address_2": "BLDG 3",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846042540",
            "telephone_number": "801-377-8000",
            "fax_number": "801-377-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 N FREEDOM BLVD",
            "address_2": "BLDG 3",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846042540",
            "telephone_number": "801-377-8000",
            "fax_number": "801-377-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLLO",
        "first_name": "KENNETH",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2011-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "3227931205",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "3227938905",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John B Zimmerman, MD
• Zion Behavioral Services LLC
• Emily Kay Zippi
• Aaron Michael Zitting, RN
• Ashley Zollinger
• Kayla Zuckerman
• Wilna Morency Zullo
• Edward John Zunkowski, LCSW
• Gina M Zupan, ACMHC
• Sade Zupan

• Pediatrics Physician in Provo, UT
• Providers in Provo, UT by specialty
• Pediatrics Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; 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.