Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly D Mikesell, PA-C

Individual provider Medical Physician Assistant · NPI 1023200888

Kelly D Mikesell, PA-C is a Physician Assistant in West Jordan, Utah. Qualified in 2007, 19 years ago. Practices with Ogden Clinic Specialty Services LLC, a 133-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Utah.

Years since qualifying
19
Licensed in
UT
In the registry since
2007
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3570 W 9000 S Ste 200
West Jordan, UT 84088-8875
Phone: (801) 566-9211
Fax: (801) 566-5667
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 5244260-1206 (UT)

Record details

NPI number1023200888
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 15, 2007
Last updated in NPPESFebruary 9, 2017

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Ogden Clinic Specialty Services Llc — 133 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in West Jordan