Active NPI
Karen W. Malm, PH.D., P.C.
- Psychologist
- Park City, UT
National Provider Identifier
1871701656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 116826-2501
- Legal business name
- KAREN W. MALM, PH.D., P.C.
- Practice address
- 4018 Rasmussen Rd
Park City, UT 84098-4705 - Phone
- (801) 599-0924
- Fax
- (435) 649-7266
- NPI assigned
- May 18, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Karen Wheelock Malm, PH.D.
- Title
- Owner
- Phone
- (801) 599-0924
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 116826-2501 | UT | Primary |
Addresses
Primary practice location
4018 Rasmussen Rd
Park City, UT 84098-4705
Mailing address
PO Box 982678
Park City, UT 84098-2678
Phone (801) 599-0924
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101527079003 | Medicaid | UT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070723000349 | UT | Part B Supplier - Clinic/Group Practice | 4284732835 |
Receives reassigned benefits from 27 practitioners Practice locations: Taylorsville, UT |
National Provider Directory
National Provider DirectoryLocations
5687 S Redwood Rd
Unit 27
Salt Lake City, UT 84123
5689 S Redwood Rd
Ste 27
Taylorsville, UT 84123
Phone (801) 266-2485
Practitioners & affiliated clinicians
Practitioners 31
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychologist
- Taylorsville, UT
- NPI 1235108812
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1871701656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 982678",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840982678",
"telephone_number": "801-599-0924",
"fax_number": "435-649-7266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4018 RASMUSSEN RD",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840984705",
"telephone_number": "801-599-0924",
"fax_number": "435-649-7266"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KAREN W. MALM, PH.D., P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-18",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MALM",
"authorized_official_first_name": "KAREN",
"authorized_official_middle_name": "WHEELOCK",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "801-599-0924",
"authorized_official_credential": "PH.D."
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": "UT",
"license": "116826-2501",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101527079003",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Park City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.