NPIMap

Individual provider Active NPI

Kathryn Casull, MD

  • Internal Medicine Physician
  • West Valley City, UT
National Provider Identifier
1831256635
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
96318227-1205 Issued in UT
Practice address
2965 W 3500 S
West Valley City, UT 84119-3602
Phone
(801) 965-3419
NPI assigned
Jan 2, 2007
Last updated
Apr 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 96318227 UT
Internal Medicine Physician 207R00000X 96318227-1205 UT Primary

Addresses

Primary practice location

2965 W 3500 S
West Valley City, UT 84119-3602

Mailing address

2965 W 3500 S
West Valley City, UT 84119-3602
Phone (801) 965-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040621001408 UT Practitioner - Internal Medicine 3779568027 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Utah School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Granger Medical Clinic PCGroup PAC ID 3476465691, 192 clinicians

Practice addresses (Care Compare)

2965 W 3500
West Valley City, UT 84119-3602
Phone (801) 965-3600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
96318227UTMDSpecialist
96318227-1205UTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Granger Medical Clinic PC Specialist CurrentSince Dec 26, 2023 Accepting new patients
Granger Medical Specialists LLC CurrentSince Oct 9, 2023 Accepting new patients
Physician Group of Utah Inc Specialist CurrentSince Oct 1, 2011 Accepting new patients
Granger Medical Specialists, LLC CurrentSince Oct 9, 2023 Accepting new patients
Nancy L McLaughlin, MD, PC Internal Medicine Past Accepting new patients
Granger Medical Clinic PC Past Accepting new patients

Locations

12391 S 4000 W
Riverton, UT 84096
Phone (801) 302-1700

1140 E 3900 S
Ste 300
Salt Lake Cty, UT 84124
Phone (385) 347-5450

348 E 4500 S
Ste 200
Salt Lake Cty, UT 84107
Phone (385) 257-6284

2530 W 4700 S
Ste B8
Taylorsville, UT 84129
Phone (801) 967-5866

995 W Levoy Dr
Taylorsville, UT 84123

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

7181 S Campus View Dr
Ste 200
West Jordan, UT 84084
Phone (801) 965-3505

2965 W 3500 S
West Valley City, UT 84119
Phone (801) 965-3505

3725 W 4100 S
West Valley City, UT 84120
Phone (801) 965-3545

Interoperability endpoints

  • Direct secure messaging: kathryn.casull@gmcwv.eclinicaldirectplus.com

Organizations & group practices 7

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1831256635",
    "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": "2965 W 3500 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841193602",
            "telephone_number": "801-965-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASULL",
        "first_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "96318227",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "96318227-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley City, UT

Sources for this page

Verify at the official NPI Registry.