Kelly Gibbons, RDN
NPI 1053107938ActiveIndividual· Dietitian, Registered· Park City, UT
Dietitian, Registered (RDN) with Ihc Health Services Inc, practicing in Park City, Utah. Enrolled in Medicare as practitioner - registered dietitian or nutrition professional.
Overview
| NPI | 1053107938 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | RDN |
| Sole proprietor | No |
| NPI issued | Apr 16, 2025 |
| Last updated in NPPES | May 14, 2025 |
| Certified by provider | May 14, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dietitian, Registered Primary | 133V00000X | 11092359-4901 | UT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Registered Dietitian Or Nutrition Professional (UT) |
|---|
Education and affiliations
| Graduation year | 2022 |
|---|---|
| Medicare specialty | Registered Dietitian Or Nutrition Professional |
Medical group
- Ihc Health Services IncMurray, UT · 3,960 clinicians
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