Kkmmcb Medical, PLLC is a Clinical Neurophysiology Physician (organization) practicing in Sandy, Utah. The National Provider Identifier (NPI) is #1033627591, which was assigned on January 18, 2018, and the registration record was last updated on January 18, 2018. The practitioner's main practice location is at 9980 South 300 West Suite 200, Sandy, UT 84070; the contact telephone number is 3852540279. The primary taxonomy of Kkmmcb Medical, PLLC is Clinical Neurophysiology Physician (2084N0600X), with specialization in Clinical Neurophysiology. The authorized official for Kkmmcb Medical, PLLC is Lizette Morin (Mdms Npi Compliance Officer).
Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS).
| NPI | 1033627591 |
| Entity Type | Organization |
| Organization Name | KKMMCB MEDICAL, PLLC |
| Provider Name | KKMMCB MEDICAL, PLLC |
| Practice Address |
9980 South 300 West Suite 200 Sandy UT 84070 |
| Practice Telephone | 3852540279 |
| Mailing Address |
1338 S Foothill Dr #331 Salt Lake City UT 84108-2321 |
| Mailing Telephone | 3852540279 |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2018-01-18 |
| Is Organization Subpart | N |
| Official Name | LIZETTE MORIN |
| Official Title | MDMS NPI COMPLIANCE OFFICER |
| Telephone | 2105982800 |
| Primary | Code | Classification | Specialization | Taxonomy Group | License Number | License State |
|---|---|---|---|---|---|---|
| N | 204R00000X | Electrodiagnostic Medicine | 193200000X MULTI-SPECIALTY GROUP | |||
| N | 2084N0400X | Psychiatry & Neurology | Neurology | 193200000X MULTI-SPECIALTY GROUP | ||
| Y | 2084N0600X | Psychiatry & Neurology | Clinical Neurophysiology | 193200000X MULTI-SPECIALTY GROUP | ||
| N | 246ZE0600X | Specialist/Technologist, Other | Electroneurodiagnostic | 193200000X MULTI-SPECIALTY GROUP |
| Code | 2084N0600X |
| Taxonomy | Clinical Neurophysiology Physician |
| Classification | Psychiatry & Neurology |
| Specialization | Clinical Neurophysiology |
| Grouping | Allopathic & Osteopathic Physicians |
| Definition: Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| Code | 204R00000X |
| Taxonomy | Electrodiagnostic Medicine Physician |
| Classification | Electrodiagnostic Medicine |
| Grouping | Allopathic & Osteopathic Physicians |
| Definition: Electrodiagnostic medicine is the medical subspecialty that applies neurophysiologic techniques to diagnose, evaluate, and treat patients with impairments of the neurologic, neuromuscular, and/or muscular systems. Qualified physicians are trained in performing electrophysiological testing and interpretation of the test data. They require knowledge in anatomy, physiology, kinesiology, histology, and pathology of the brain, spinal cord, autonomic nerves, cranial nerves, peripheral nerves, neuromuscular junction, and muscles. They must know clinical features and treatment of diseases of the central, peripheral, and autonomic nervous systems, as well as those of neuromuscular junction and muscle. Physicians also require special knowledge about electric signal processing, including waveform analysis, electronics and instrumentation, stimulation and recording equipment, and statistics. |
| Notes: Source: American Association of Neuromuscular & Electrodiagnostic Medicine, 2011. www.aanem.org [1/1/2011: new] Additional Resources: American Board of Electrodiagnostic Medicine, 2011. www.abemexam.org |
| Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| Grouping | Allopathic & Osteopathic Physicians |
| Definition: A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| Code | 246ZE0600X |
| Taxonomy | Electroneurodiagnostic Specialist/Technologist |
| Classification | Specialist/Technologist, Other |
| Specialization | Electroneurodiagnostic |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Definition: Definition to come... |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Elyaderani Neurological Associates PC | 140 Lockwood Ave Ste 103, New Rochelle, NY 10801-4907 | Clinical Neurophysiology Physician | 2025-02-07 |
| Lto Healthcare Management | 5012 Geddings St, Lake Charles, LA 70605-6761 | Clinical Neurophysiology Physician | 2024-07-10 |
| Neuro Management Solutions, LLC | 20111 Fm 2100 Rd Ste 222, Crosby, TX 77532-3731 | Clinical Neurophysiology Physician | 2023-07-27 |
| Inland Empire Brain Experts Corp | 6485 Day St Ste 103, Riverside, CA 92507-0930 | Clinical Neurophysiology Physician | 2025-01-10 |
| Interventional Pain & Spine Center PLLC | 100 Bradford Road, Ste 410, Wexford, PA 15090-8489 | Clinical Neurophysiology Physician | 2024-06-05 |
| Ps Medical PLLC | 22 Stonehurst Dr, Tenafly, NJ 07670-2915 | Clinical Neurophysiology Physician | 2022-05-18 |
| Synergy Psychiatry and Wellness, PLLC | 203 Champion Way Ste 7, Georgetown, KY 40324-8861 | Clinical Neurophysiology Physician | 2024-08-13 |
| Bls Diagnostics, LLC | 6911 Laurel Bowie Rd Ste 212, Bowie, MD 20715-1712 | Clinical Neurophysiology Physician | 2024-01-08 |
| Neuroelite Services LLC | 813 N Lenz Dr, Anaheim, CA 92805-1728 | Clinical Neurophysiology Physician | 2023-08-29 |
| Yuma Tms PLLC | 1030 W 24th St Ste C-2, Yuma, AZ 85364-8319 | Clinical Neurophysiology Physician | 2024-11-22 |
| Find all providers with the same taxonomy | |||
| Street Address |
1338 S FOOTHILL DR #331 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84108-2321 |
| Country | US |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Project Recovery, Inc. | 1338 Foothill Dr, 162, Salt Lake City, UT 84108-2321 | Substance Abuse Rehabilitation Facility | 2011-05-18 |
| Dans Supermarkets Inc | 1360 Foothill Blvd, Slc, UT 84108-2321 | Community/Retail Pharmacy | 2006-08-30 |
| Adriane Andersen | 1338 S Foothill Dr # 216, Salt Lake City, UT 84108-2321 | Mental Health Counselor | 2013-11-27 |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Kylee Ford | 501 Chipta Way, Salt Lake City, UT 84108 | Social Worker | 2022-01-09 |
| Bryon Claflin | 650 S Komas Ste 200, Salt Lake City, UT 84108 | Registered Nurse | 2016-03-08 |
| Emilie C. Morris | 100 Woodruff Cir Ne Ste 231, Salt Lake City, UT 84108 | Pediatrics Physician | 2021-12-12 |
| Kayla Ozawa | 592 Guardsman Way, Salt Lake City, UT 84108 | Athletic Trainer | 2020-05-22 |
| Dylan Marashi | 501 Chipeta Way, Salt Lake City, UT 84108 | Student in an Organized Health Care Education/Training Program | 2024-03-29 |
| Ashley Cafferty | 565 Komas Drive, Salt Lake City, UT 84108 | Student in an Organized Health Care Education/Training Program | 2019-07-16 |
| Uni Home Program | 650 S Komas, Suite 200, Salt Lake City, UT 84108 | Psychiatric Hospital | 2015-05-01 |
| Ryan Weisenbeck | 580 S Guardsman Way, Salt Lake City, UT 84108 | Athletic Trainer | 2016-08-31 |
| Lcr Dental Sugar House | 2068 S 2100 E Suite #A, Salt Lake City, UT 84108 | Pediatric Dentist | 2017-10-16 |
| Cancer Survivor Health Network, L.L.C. | 2486 East Emerson Avenue, Salt Lake City, UT 84108 | Specialist | 2017-09-11 |
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| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| U Medical PLLC | 1800 E Van Buren St, Phoenix, AZ 85006-3742 | Internal Medicine Physician | 2023-06-16 |
| Msp Medical PLLC | 17330 Preston Rd Ste 200d, Dallas, TX 75252-6106 | Interventional Pain Medicine Physician | 2018-10-11 |
| Lm Medical PLLC | 33 5th Ave, Suite 1b, New York, NY 10003-4377 | Dermatology Physician | 2016-04-12 |
| Alr Medical PLLC | 8636 Luz Dr, Odessa, TX 79765-2428 | Family Nurse Practitioner | 2024-10-07 |
| Htc Medical, PLLC | 5005 W Royal Ln, Ste 196, Irving, TX 75063-1996 | Clinical Neurophysiology Physician | 2014-10-22 |
| Lwn Medical PLLC | 3401 Lockwood Dr, Lakeside, AZ 85929-5613 | Skilled Nursing Facility | 2011-08-30 |
| Alyve Medical PLLC Family Medical Clinic | 1480 N Green Mount Rd Ste 200, O Fallon, IL 62269-3466 | Internal Medicine Physician | 2021-12-20 |
| Abx Medical PLLC | 2523 Simon Ln Ne, Olympia, WA 98506-3553 | Internal Medicine Physician | 2020-07-15 |
| U Medical PLLC | 4545 N Hunt Hwy, Florence, AZ 85132-6937 | Internal Medicine Physician | 2023-06-16 |
| Kivela Medical, PLLC (Dba:The Medical Associates) | 511 E John Carpenter Fwy Ste 500, Irving, TX 75062-8138 | Psychiatry Physician | 2023-07-26 |
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This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.
| Subject | Transparency and Disclosure |
| Jurisdiction | Federal |
| Data Provider | National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS) |
| Source | download.cms.gov |
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid). Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008. This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information. |