NPIMap

Organization Active NPI

Karen W. Malm, PH.D., P.C.

  • Psychologist
  • Park City, UT
National Provider Identifier
1871701656
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
116826-2501 Issued in UT
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
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Karen Wheelock Malm, PH.D.NPI 1235108812
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)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070723000349 UT Part B Supplier - Clinic/Group Practice 4284732835 Receives reassigned benefits from 27 practitioners
Practice locations: Taylorsville, UT

National Provider Directory

National Provider Directory

Locations

5689 S Redwood Rd
Ste 27
Taylorsville, UT 84123
Phone (801) 266-2485

5689 S Redwood Rd
Unit 27
Taylorsville, UT 84123
Phone (801) 266-2485

Practitioners & affiliated clinicians

Practitioners 47

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 47

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": [],
    "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.

Verify at the official NPI Registry.