KIM A. HALLADAY (NPI# 1902809528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902809528 |
| Entity Type | Individual |
| Full Name | KIM A. HALLADAY |
| Credential | D.P.M. |
| Practice Address |
2356 N 400 E Ste 104 Tooele UT 84074-3409 |
| Practice Telephone | 4358820711 |
| Practice Fax Number | 4358821778 |
| Mailing Telephone | 4358820711 |
| Mailing Fax Number | 4358821778 |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2010-12-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 103966-0501 | UT | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | EMIA | 870406457 HA1 | 01 |
| UT | DME | 0994190001 | 01 |
| UT | TRICARE | 870406457 84074 | 01 |
| UT | DMBA | 36338 | 01 |
| UT | ALTIUS | QM0000054283 | 01 |
| UT | IHC | 107006704101 | 01 |
| UT | PEHP | 2649 | 01 |
| UT | RAILROAD MEDICARE | 480008495 | 01 |
| Street Address |
2356 N 400 E STE 104 |
| City | TOOELE |
| State | UT |
| Zip Code | 84074-3409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598295586 | Bradley Allen Klemetson | Physical Therapist | 2356 N 400 E, Tooele, UT 84074-3409 | 2017-06-13 |
| 1013466978 | Jesse Yarrington | Physician Assistant | 2356 N 400 E, Ste 201, Tooele, UT 84074-3409 | 2016-10-03 |
| 1851767495 | Kenneth David Brown | Physical Therapist | 2356 N 400 E, Tooele, UT 84074-3409 | 2015-08-18 |
| 1205178571 | Joshua Scott Ingleby | Physician Assistant | 2356 N 400 E, Ste 201, Tooele, UT 84074-3409 | 2013-03-25 |
| 1497011605 | Acg Counseling Services, LLC | Counselor | 2356 N 400 E, Suite 202, Tooele, UT 84074-3409 | 2012-04-02 |
| 1366719015 | Jim J. Gould, Md PC | Clinic/Center | 2356 N 400 E, Suite 202, Tooele, UT 84074-3409 | 2011-11-23 |
| 1699004499 | Tooele Valley Imaging, LLC | Clinic/Center | 2356 N 400 E, Suite 103, Tooele, UT 84074-3409 | 2009-12-08 |
| 1255509154 | Tooele Foot & Ankle Clinic, Inc. | Podiatrist | 2356 N 400 E, Ste 104, Tooele, UT 84074-3409 | 2008-02-13 |
| 1770766586 | Sergio Abarca, M.d., Inc | Family Medicine | 2356 N 400 E, Ste 201, Tooele, UT 84074 | 2007-12-14 |
| 1184807992 | Blake R. Beazer, M.d., Inc | Family Medicine | 2356 N 400 E, Ste. 201, Tooele, UT 84074-3409 | 2007-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689233397 | Leah Elizabeth Harper I | Behavior Technician | 39 Millpond Stansbury Park, Tooele, UT 84074 | 2019-06-07 |
| 1245710789 | Tanna Marie Shelley | Community Health Worker | 27 So Main St, Tooele, UT 84074 | 2018-08-15 |
| 1528548062 | Barbara T Cederlof | Community Health Worker | 27 South Main St., Tooele, UT 84074 | 2018-08-15 |
| 1235615600 | Ashley Christine Wilson | Case Manager/Care Coordinator | 27 South Main, Tooele, UT 84074 | 2018-07-18 |
| 1174016976 | Makenzie Green | Case Manager/Care Coordinator | 27 S Main, Tooele, UT 84074 | 2018-06-07 |
| 1386151835 | Monica Lee | Physical Therapist | 6727 Ut-36 #300, Stansbury Park, UT 84074 | 2018-01-05 |
| 1871976183 | Pagnani Physical Therapy | Physical Therapist | 6727 North State Hwy 36, Suite 300, Stansbury Park, UT 84074 | 2015-07-06 |
| 1407248222 | Pebble Creek Counseling Center | Counselor | 494 E 2400 N Ste B, Tooele, UT 84074 | 2015-03-03 |
| 1528496221 | Emily Carlson | Case Manager/Care Coordinator | 220 North Millpond Rd, Suite 100, Stansbury Park, UT 84074 | 2013-10-16 |
| 1710327218 | Angela Michelle Demoss | Nurse Practitioner | 682 Country Club, Stansbury Park, UT 84074 | 2013-06-28 |
| Find all providers in zip 84074 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922589258 | Valley Foot & Ankle | Podiatrist | 777 N 500 W Ste 103, Provo, UT 84601-1552 | 2018-08-24 |
| 1821514191 | Foot & Ankle Institute of Utah LLC | Podiatrist | 3584 W 9000 S Ste 301, West Jordan, UT 84088-5711 | 2017-08-18 |
| 1447771993 | Ihc Health Services Inc | Podiatrist | 201 W Layton Parkway, Layton, UT 84041 | 2017-07-05 |
| 1720514268 | Utah Podiatric Physicians and Surgeons Group LLC | Podiatrist | 7000 S 1561 W, #100, West Jordan, UT 84084 | 2017-05-03 |
| 1043745987 | Utah Podiatric Physicians and Surgeons Group LLC | Podiatrist | 150 N Main St Ste 202, Heber City, UT 84032-1671 | 2017-04-28 |
| 1205214053 | Elizabeth Tronstein | Podiatrist | 8822 S Redwood Rd Ste E121, West Jordan, UT 84088-5763 | 2015-05-13 |
| 1063807485 | Salt Lake Foot and Ankle Pllc | Podiatrist | 315 W Reed Ave, Unit 1, Salt Lake City, UT 84103-1492 | 2015-04-02 |
| 1881091601 | Ingrown Toenails Only | Podiatrist | 4019 W 12600 S Ste 120b, Riverton, UT 84096-7401 | 2014-11-21 |
| 1750794533 | Scott Humpherys, Dpm Inc | Podiatrist | 1355 N. University Ave, #125, Provo, UT 84604-2722 | 2014-06-09 |
| 1508115080 | Richard Eason Dpm PC | Podiatrist | 2269 W Bonanza Ct, South Jordan, UT 84095-8903 | 2012-08-30 |
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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.