Individual provider Active NPI

Kevin Walkenhurst, PHARMD

  • Pharmacist
  • Midvale, UT
National Provider Identifier
1972324424
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5806603-1701 Issued in UT
Practice address
7495 S State St
Midvale, UT 84047-2013
Phone
(801) 213-9540
Fax
(801) 213-9553
NPI assigned
Oct 17, 2024
Last updated
Oct 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5806603-1701 UT Primary
Pharmacist 183500000X S018515 AZ

Addresses

Primary practice location

7495 S State St
Midvale, UT 84047-2013

Mailing address

7495 S State St
Midvale, UT 84047-2013
Phone (801) 213-9540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
S018515AZMDPharmacist
5806603-1701UTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1972324424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7495 S STATE ST",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840472013",
            "telephone_number": "801-213-9540",
            "fax_number": "801-213-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7495 S STATE ST",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840472013",
            "telephone_number": "801-213-9540",
            "fax_number": "801-213-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKENHURST",
        "first_name": "KEVIN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-17",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "5806603-1701",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S018515",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midvale, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.