Kelly Allan Gomez, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

367951 Issued in UT

Practice address

777 N 500 W
Suite 103
Provo, UT 84601

Phone

(801) 375-6677

Fax

(801) 375-0346

NPI assigned

Jul 9, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

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.

• Kelly a Gomez DPM PC

  dba Rocky Mountain Foot and Ankle

  • Podiatric Clinic/Center
  • Provo, UT
  • NPI 1306092812
  Authorized official Same address or phone
• Rocky Mountain Foot and Ankle Clinic

  • Foot & Ankle Surgery Podiatrist
  • Provo, UT
  • NPI 1356416770
  NPD (past) Authorized official
• Valley Foot & Ankle

  • Podiatrist
  • Provo, UT
  • NPI 1922589258
  Authorized official Same address or phone
• Foot & Ankle Clinics of Utah, P.C.

  • Podiatrist
  • Orem, UT
  • NPI 1508994955
  NPD (past)

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1821021957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 N 500 W",
            "address_2": "SUITE 103",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84601",
            "telephone_number": "801-375-6677",
            "fax_number": "801-375-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 N 500 W",
            "address_2": "SUITE 103",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84601",
            "telephone_number": "801-375-6677",
            "fax_number": "801-375-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "KELLY",
        "middle_name": "ALLAN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "UT",
            "license": "367951",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "UT",
            "license": "367951",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN #",
            "identifier": "000064004",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Gabriel Golden
• Zachary David Golden, PA
• Elizabeth Golightly
• Thomas Golightly
• Christian Gomez, DC
• Robert Gomm, EDS
• Giovani Gongora
• Brett Esteban Gonzalez, LCSW
• Cassidy Elaine Gonzalez
• Dereck Hugh Gonzalez, CSW

• Foot & Ankle Surgery Podiatrist in Provo, UT
• Providers in Provo, UT by specialty
• Foot & Ankle Surgery Podiatrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; 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.