Individual provider Active NPI

Kent M Gledhill, MD

  • Diagnostic Radiology Physician
  • Provo, UT
National Provider Identifier
1871539833
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
338798-1205 Issued in UT
Practice address
1055 N 500 W
Suite 112
Provo, UT 84604-3305
Phone
(801) 812-4624
Fax
(801) 812-4699
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 338798-1205 UT Primary

Addresses

Primary practice location

1055 N 500 W
Suite 112
Provo, UT 84604-3305

Mailing address

1055 N 500 W
Credentialing Department
Provo, UT 84604-3305
Phone (801) 354-8225

Other practice location 1

555 W State Road 164
Salem, UT 84653-5732
Phone (801) 812-4624

Other practice location 2

3000 N Triumph Blvd
Lehi, UT 84043-7186
Phone (385) 345-3155

Other practice location 3

1175 E 50 S Ste 141
American Fork, UT 84003-2845
Phone (801) 492-5996

Other practice location 4

2825 E Mall Dr
St George, UT 84790-1954
Phone (435) 986-2238

Other identifiers 7

IdentifierTypeStateIssuer
P00157756OtherPALMETTO GBA
219637OtherUTALTIUS
311124OtherUTDMBA
870281028KETOtherUTEMIA
107001825102OtherUTIHC
79255OtherUTPEHP
16-00689OtherUTUNITED HEALTHCARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address medreveiw@reverehealth.com Central Utah Clinic, P.C.

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040802000599 UT Practitioner - Diagnostic Radiology 7315918794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Utah School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revere Health PCGroup PAC ID 7517868508, 407 clinicians

Practice addresses (Care Compare)

1055 N 500
Provo, UT 84604-3305
Phone (801) 429-8000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Aug 1, 2004 Accepting new patients
Revere Health PC CurrentSince Aug 1, 2004 Accepting new patients

Locations

1175 E 50 S
Ste 211
American Fork, UT 84003
Phone (801) 418-0807

1175 E 50 S
Ste 141
American Fork, UT 84003
Phone (801) 492-5996

3000 N Triumph Blvd
Lehi, UT 84043
Phone (385) 345-3000

3000 N Triumph Blvd
Ste 100
Lehi, UT 84043
Phone (385) 345-3155

750 W 800 N
Orem, UT 84057
Phone (801) 714-6000

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

1055 N 500 W
Ste 112
Provo, UT 84604
Phone (801) 812-4624

1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362

852 N 500 W
Provo, UT 84604
Phone (801) 357-4417

555 W State Road 164
Salem, UT 84653
Phone (801) 465-4896

1490 E Foremaster Dr
Bldg C
St George, UT 84790
Phone (435) 674-5230

2825 E Mall Dr
St George, UT 84790
Phone (435) 673-6131

Interoperability endpoints

  • Direct secure messaging: kentgledhill@cuccu.allscriptsdirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1871539833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "address_2": "CREDENTIALING DEPARTMENT",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "address_2": "SUITE 112",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-812-4624",
            "fax_number": "801-812-4699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 W State Road 164",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "UT",
            "postal_code": "846535732",
            "country_code": "US",
            "telephone_number": "801-812-4624",
            "fax_number": "801-812-4699",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3000 N Triumph Blvd",
            "address_purpose": "LOCATION",
            "city": "Lehi",
            "state": "UT",
            "postal_code": "840437186",
            "country_code": "US",
            "telephone_number": "385-345-3155",
            "fax_number": "385-345-3163",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1175 E 50 S Ste 141",
            "address_purpose": "LOCATION",
            "city": "American Fork",
            "state": "UT",
            "postal_code": "840032845",
            "country_code": "US",
            "telephone_number": "801-492-5996",
            "fax_number": "801-492-5993",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2825 E Mall Dr",
            "address_purpose": "LOCATION",
            "city": "St George",
            "state": "UT",
            "postal_code": "847901954",
            "country_code": "US",
            "telephone_number": "435-986-2238",
            "fax_number": "435-986-2237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLEDHILL",
        "first_name": "KENT",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "338798-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "P00157756",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS",
            "identifier": "219637",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMBA",
            "identifier": "311124",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMIA",
            "identifier": "870281028KET",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHC",
            "identifier": "107001825102",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "79255",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "16-00689",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreveiw@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Central Utah Clinic, P.C.",
            "address_1": "1055 N 500 W",
            "address_2": "Suite 112",
            "city": "Provo",
            "state": "UT",
            "country_code": "US",
            "postal_code": "846043305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.