Organization Active NPI

Kent B McDonald M.D Perffesional

  • Internal Medicine Physician
  • St George, UT
National Provider Identifier
1881862076
Registry record updated Jul 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
06469 Issued in UT
Legal business name
KENT B MCDONALD M.D PERFFESIONAL
Practice address
515 S 300 E
Suite 105
Saint George, UT 84770-3900
Phone
(435) 628-2814
Fax
(435) 674-7112
NPI assigned
Feb 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2013

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

Authorized official

Name
Kent B McDonald, M.D.
Title
Owner
Phone
(435) 628-2814

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 06469 UT Primary

Addresses

Primary practice location

515 S 300 E
Suite 105
Saint George, UT 84770-3900

Mailing address

515 S 300 E
Suite 105
Saint George, UT 84770-3900
Phone (435) 628-2814

Other identifiers 1

IdentifierTypeStateIssuer
529647916001MedicaidUT

National Provider Directory

National Provider Directory

Locations

515 S 300 E
Ste 105
St George, UT 84770
Phone (435) 628-2814

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373241600000",
    "number": "1881862076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 S 300 E",
            "address_2": "SUITE 105",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847703900",
            "telephone_number": "435-628-2814",
            "fax_number": "435-674-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S 300 E",
            "address_2": "SUITE 105",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847703900",
            "telephone_number": "435-628-2814",
            "fax_number": "435-674-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT B MCDONALD M.D PERFFESIONAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-11",
        "last_updated": "2013-07-08",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-628-2814",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "06469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529647916001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.