Kyle Allan Vance
Physician Assistant in South Jordan, UT. Individual provider (NPI-1).
NPI number1003469867
StatusActive
Last updated in NPPESJul 22, 2019
Details
- NPI
- 1003469867
- Entity type
- Individual (NPI-1)
- Name
- Kyle Allan Vance
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 22, 2019
- Last updated
- Jul 22, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 11353630-1206 | UT | Yes |
Practice location
10433 S Redwood Rd Ste BSouth Jordan, UT 84095-8502
Phone 801-260-1919
Mailing address
Po Box 95590South Jordan, UT 84095-0590
Phone 801-352-9500 · Fax 801-352-7976
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 36 Physician Assistant providers in South Jordan · All 1,565 providers in South Jordan
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