KELLY ALLAN GOMEZ (NPI# 1821021957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821021957 |
| Entity Type | Individual |
| Full Name | KELLY ALLAN GOMEZ |
| Credential | DPM |
| Practice Address |
777 N 500 W Suite 103 Provo UT 84601 |
| Practice Telephone | 8013756677 |
| Practice Fax Number | 8013750346 |
| Mailing Telephone | 8013756677 |
| Mailing Fax Number | 8013750346 |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2015-01-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | 367951 | UT | Podiatric Medicine & Surgery Service Providers |
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
367951 | UT | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | MEDICARE PTAN # | 000064004 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194379008 | Kelly Marie Gomez | Behavior Technician | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2019-07-29 |
| 1376009316 | Kelly Gomez | Physical Therapist | 5225 S Loop 289 Ste 210, Lubbock, TX 79424-1319 | 2019-02-14 |
| 1508228305 | Kelly Gomez | Pharmacist | 10800 N Beach St, Fort Worth, TX 76244-8541 | 2016-03-22 |
| 1669860607 | Kelly Gomez | Behavioral Analyst | 11755 Sw 90th St, Miami, FL 33186-2177 | 2014-12-29 |
| Street Address |
777 N 500 W SUITE 103 |
| City | PROVO |
| State | UT |
| Zip Code | 84601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699746529 | Jeffrey A Youngquist | Dentist | 777 N 500 W, Suite #201-a, Provo, UT 84601-1541 | 2006-01-30 |
| 1205288586 | Lyndi Jenson | Dentist | 777 N 500 W, Provo, UT 84601-1541 | 2016-07-11 |
| 1922474956 | Rock Canyon Dentistry | Dentist | 777 N 500 W, #105, Provo, UT 84601-1541 | 2015-08-13 |
| 1700295227 | All Around Dental Care, Lc | Dentist | 777 N 500 W, Ste 106, Provo, UT 84601-1541 | 2014-08-08 |
| 1164846044 | Kyle Kone | Marriage & Family Therapist | 777 N 500 W, #104, Provo, UT 84601-1541 | 2014-02-12 |
| 1063833721 | Life Integrative Health Center | Clinic/Center | 777 N 500 W, Suite 104, Provo, UT 84601-1541 | 2013-12-26 |
| 1376985721 | Canyon View Medical Group LLC | Obstetrics & Gynecology | 777 N 500 W, Suite 203, Provo, UT 84601 | 2013-07-26 |
| 1306186952 | Edison Stanford Hearing Aid Center | Hearing Aid Equipment | 777 N 500 W, Suite 005, Provo, UT 84601-1541 | 2013-02-19 |
| 1861755571 | Devin Lynn Davidson | Dentist | 777 N 500 W, Suite 106, Provo, UT 84601-1541 | 2012-06-18 |
| 1932473188 | All Around Dental Care | Dentist | 777 N 500 W, 106, Provo, UT 84601-1541 | 2012-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902378417 | 1 Assist Care of Utah Valley LLC | In Home Supportive Care | 180 N University Avenue, Suite 270, Office 213, Provo, UT 84601 | 2018-12-21 |
| 1346723319 | Mp Dental LLC | Dentist | 777 N. 500 W. #204, Proud, UT 84601 | 2018-09-14 |
| 1326530601 | Madison Paige Nelson | Case Manager/Care Coordinator | 750 N Freedom Blvd., Provo, UT 84601 | 2018-06-03 |
| 1245758861 | Annette Roylance | Case Manager/Care Coordinator | 750 North Freedom Boulevard, Suite 300, Provo, UT 84601 | 2017-09-04 |
| 1912422205 | Alexandra Mcbride | Specialist/Technologist | 35 N 300 W #440, Provo, UT 84601 | 2017-08-07 |
| 1932638293 | Audrey Clara Clifton | Case Manager/Care Coordinator | 750 North Freedom Blvd., Provo, UT 84601 | 2017-06-08 |
| 1528514197 | Joseph Hyrum Lewis | Case Manager/Care Coordinator | 750 Freedom Blvd, Provo, UT 84601 | 2016-09-01 |
| 1629427620 | Walker Clements | Case Manager/Care Coordinator | 750 North Freedom Blvd, Provo, UT 84601 | 2016-06-09 |
| 1447611595 | Robert Shirley | Student in an Organized Health Care Education/Training Program | 750 North 200 West, Provo, Ut 84601., Provo, UT 84601 | 2016-03-17 |
| 1700286283 | Brelynn Downs | Student in an Organized Health Care Education/Training Program | 750 North Freedom Blvde, Provo, UT 84601 | 2014-09-03 |
| Find all providers in zip 84601 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295001683 | Cascade Foot and Ankle Clinic PC | Podiatrist | 1973 North State St, Provo, UT 84604-5711 | 2012-03-29 |
| 1942338496 | Cascade Foot and Ankle Clinic PC | Podiatrist | 1973 N State St, Provo, UT 84604-5711 | 2007-02-28 |
| 1790726487 | H Gary Morley | Podiatrist | 1275 N University Ave, Suite 12, Provo, UT 84604-7123 | 2006-06-10 |
| 1457737579 | Utah Podiatry Group PC | Podiatrist | 1973 North State Street, Provo, UT 84604-1012 | 2015-07-31 |
| 1326428061 | Garr Foot & Ankle Pllc | Podiatrist | 1355 N University Ave, Ste 125, Provo, UT 84604-2721 | 2015-06-08 |
| 1215315817 | Todd Joseph Jaramillo | Podiatrist | 3355 N University Ave Ste 175, Provo, UT 84604 | 2015-05-14 |
| 1285980094 | Randy Garr | Podiatrist | 1355 N University Ave, Ste 125, Provo, UT 84604-2721 | 2012-07-30 |
| 1881729507 | Central Utah Foot Clinic, LLC | Podiatrist | 150 W 800 N, Provo, UT 84601-1624 | 2007-02-22 |
| 1356416770 | Rocky Mountain Foot and Ankle Clinic | Podiatrist | 777 N 500 W, Suite 105, Provo, UT 84601-1541 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033721303 | Stride Foot and Ankle Pllc | Podiatrist | 1365 W 1250 S Ste 101, Orem, UT 84058-2303 | 2020-08-18 |
| 1700369014 | Utah Podiatry Group PC | Podiatrist | 6321 S Redwood Rd Ste 102, Taylorsville, UT 84123-6799 | 2018-09-12 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| 1447773122 | Apex Foot and Ankle Institute | Podiatrist | 882 N Main St # 2, Richfield, UT 84701-1840 | 2017-07-25 |
| 1902328644 | Weston Charles Packard | Podiatrist | 1561 W 7000 S Ste 201, West Jordan, UT 84084-3556 | 2017-07-14 |
| 1053844753 | Elite Ankle and Foot Pllc | Podiatrist | 39 E Center Street, Gunnison, UT 84634 | 2017-04-10 |
| 1811341621 | Victor Kent Myers | Podiatrist | 754 S Main St Ste 3, St George, UT 84770-5505 | 2016-04-18 |
| 1598119463 | Landon Cameron | Podiatrist | 1490 E Foremaster Dr Ste 250, St George, UT 84790-4501 | 2016-04-18 |
| 1417338161 | Adam Bowen Wood | Podiatrist | 1248 E 90 N Ste 101, American Fork, UT 84003-2954 | 2015-06-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.