Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelli Elaine Groomer, PA

Individual provider Physician Assistant · NPI 1568412724

Kelli Elaine Groomer, PA is a Physician Assistant in Salt Lake City, Utah. Qualified in 2005, 21 years ago. Practices with Ihc Health Services Inc, a 3,947-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois and Utah.

Years since qualifying
21
Licensed in
IL, UT
In the registry since
2006
Specialties on file
4
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

8 Th Ave & C St
Salt Lake City, UT 84143-0001
Phone: (801) 408-3729
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 6063472-1206 (UT)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 6063472-1206 (UT)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 085.004349 (IL)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 385.003199 (IL)

Record details

NPI number1568412724
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 10, 2006
Last updated in NPPESNovember 10, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Ihc Health Services Inc — 3947 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations11 on file with Medicare

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