Individual provider Active NPI

Kyalee Jade Vandam, PA

  • Physician Assistant
  • Layton, UT
National Provider Identifier
1851271811
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14265499-1206 Issued in UT
Practice address
201 W Layton Pkwy Ste 1a
Layton, UT 84041-3692
Phone
(801) 543-6875
NPI assigned
Sep 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 14265499-1206 UT Primary

Addresses

Primary practice location

201 W Layton Pkwy Ste 1a
Layton, UT 84041-3692

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Bluemark LLC/ Office Ally

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260303003690 UT Practitioner - Physician Assistant 5092297689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

201 W Layton Pkwy
Suite 1a
Layton, UT 84041-3692
Phone (801) 543-6750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
14265499-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Mar 30, 2026 Accepting new patients
Ihc Health Services Inc CurrentSince Mar 30, 2026 Accepting new patients

Locations

201 W Layton Pkwy
Ste 1A
Layton, UT 84041
Phone (801) 543-5875

1300 SE Cardinal Ct
Ste 190
Vancouver, WA 98683
Phone (360) 448-4479

Organizations & group practices 3

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": "1756771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1851271811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W LAYTON PKWY STE 1A",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840413692",
            "telephone_number": "801-543-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDAM",
        "first_name": "KYALEE",
        "middle_name": "JADE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-02",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "14265499-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC/ Office Ally",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.