Kevin L Jansen (NPI# 1013908995, PAC ID# 8123919198) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEPHROLOGY.
| Nation Provider ID (NPI) | 1013908995 |
| PAC ID by PECOS | 8123919198 |
| Professional Enrollment ID | I20070531000368 |
| Full Name | Kevin L Jansen |
| Organization Legal Name | NEPHROLOGY ASSOCIATES OF UTAH,L.L.C. |
| Address |
3702 S State St Suite 107 S Salt Lake UT 84115-5096 |
| Phone Number | 8012882634 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF IOWA COLLEGE OF MEDICINE |
| Graduation Year | 1999 |
| Primary Specialty | NEPHROLOGY |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 2769468065 |
| Number of Group Practice Members | 18 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 460010 | INTERMOUNTAIN MEDICAL CENTER |
| 460058 | RIVERTON HOSPITAL |
| 460006 | LDS HOSPITAL |
| 460051 | JORDAN VALLEY MEDICAL CENTER |
| 460047 | ST MARK'S HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 3702 S State St, Suite 107, S Salt Lake, UT 84115-5096 | 8012882634 | NEPHROLOGY ASSOCIATES OF UTAH,L.L.C. |
| Organization Legal Name | NEPHROLOGY ASSOCIATES OF UTAH,L.L.C. |
| Physicians | 14 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Wendy Jane Frey | Nurse Practitioner | Nephrology Associates of Utah,l.l.c. | 12523 S Creek Meadow Rd, Riverton, UT 84065-7291 |
| Dave Tien | Nephrology | Nephrology Associates of Utah,l.l.c. | 572 W 750, Bountiful, UT 84010-7265 |
| Jerald P Boseman | Nephrology | Nephrology Associates of Utah,l.l.c. | 121 S Orem Blvd, Suite 103, Orem, UT 84058-3006 |
| Donner Anne Schweitzer | Nurse Practitioner | Nephrology Associates of Utah,l.l.c. | 3702 S State St, Suite 107, S Salt Lake, UT 84115-5096 |
| Minerva A Dantis Tan | Nurse Practitioner | Nephrology Associates of Utah,l.l.c. | 572 W 750, Bountiful, UT 84010-7265 |
| Phyllis A Aseltine | Nurse Practitioner | Nephrology Associates of Utah,l.l.c. | 3702 S State St, Suite 107, S Salt Lake, UT 84115-5096 |
| Jeff Anthony Barklow | Nephrology | Nephrology Associates of Utah,l.l.c. | 572 W 750, Bountiful, UT 84010-7265 |
| Hasan Joseph Salameh | Nephrology | Nephrology Associates of Utah,l.l.c. | 572 W 750, Bountiful, UT 84010-7265 |
| Ruth Merry Indahyung | Nephrology | Nephrology Associates of Utah,l.l.c. | 572 W 750, Bountiful, UT 84010-7265 |
| Sey Mon Lau | Nephrology | Nephrology Associates of Utah,l.l.c. | 572 W 750, Bountiful, UT 84010-7265 |
| Street Address |
3702 S STATE ST SUITE 107 |
| City | S SALT LAKE |
| State | UT |
| Zip | 84115-5096 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Donner Anne Schweitzer | Nurse Practitioner | Nephrology Associates of Utah,l.l.c. | 3702 S State St, Suite 107, S Salt Lake, UT 84115-5096 |
| Phyllis A Aseltine | Nurse Practitioner | Nephrology Associates of Utah,l.l.c. | 3702 S State St, Suite 107, S Salt Lake, UT 84115-5096 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jill B Jones | Clinical Social Worker | 404 E 1700, Salt Lake City, UT 84115-1732 | |
| Mark M Mckell | Optometry | Salt Lake City Eye Care, LLC | 1818 S 300, Salt Lake City, UT 84115-1805 |
| Ryan Toone Barlow | Optometry | Salt Lake City Eye Care, LLC | 1818 S 300, Salt Lake City, UT 84115-1805 |
| Nathan R Green | Optometry | Nathan Green Od PC | 241 W 2100, South Salt Lake, UT 84115-1830 |
| Melanie Squire | Clinical Social Worker | 140 W 2100, Suite 244, Salt Lake City, UT 84115-1980 | |
| Esther Ewell | Clinical Social Worker | Military and Veteran Counseling Center LLC | 140 W 2100, Suite 244, Salt Lake City, UT 84115-1980 |
| Taylor R Krick | Chiropractic | 1860 S 300 W B, Salt Lake City, UT 84115-2198 | |
| Morgan C Galbraith | Nurse Practitioner | Successor Healthcare LLC | 451 E Bishop Federal Ln, Salt Lake City, UT 84115-2357 |
| Robert L Mazzola | Sleep Medicine | Ihc Health Services Inc | 451 Bishop Federal Ln, Salt Lake City, UT 84115-2357 |
| Willy Mack Taylor | Physician Assistant | Successor Healthcare LLC | 451 E Bishop Federal Ln, Salt Lake City, UT 84115-2357 |
| Find all physicians in zip 84115 | |||
| City | S SALT LAKE |
| Zip Code | 84115 |
| Specialty | NEPHROLOGY |
| City + Specialty | S SALT LAKE + NEPHROLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.