GRACE KIM HARRIS (DO) – Family Medicine Physician, NPI 1093725277

GRACE KIM HARRIS (DO) is a healthcare provider. based in Midvale, Utah. specializing in Family Medicine Physician. They hold the professional credentials DO. They hold a License No. 53924561204 (UT). The NPI Number for GRACE KIM HARRIS (DO) is 1093725277

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
GRACE KIM HARRIS (DO)
NPI
1093725277
Phone
(801) 233-4400
Address
1225 E FORT UNION BLVD
Enumeration Date
9 August 2006
Last Update Date
25 January 2022

Doctor Profile

Medical School Name
UNIVERSITY OF PIKEVILLE, KENTUCKY COLLEGE OF OSTEOPATHIC MED
Secondary Phone
-
Graduation Year
2002 (24 years ago)
PAC ID
3072591759
Group Practice PAC ID
1850209420
Professional Enrollment ID
I20040709000434

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

Provider Addresses for GRACE KIM HARRIS (DO)

  • 1225 E FORT UNION BLVD

    SUITE 200

    MIDVALE, UT 840471889

    Phone: (801) 233-4400

    Fax: (801) 233-4410

    Type: Location

  • Fort Union Boulevard, Essex Court Condo, Midvale, Salt Lake County, Utah, 84127, United States

    SUITE 200

    MIDVALE, UT 840471889

    Phone: (801) 233-4400

    Fax: (801) 233-4410

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-01-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230127001530IFamily PracticeCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84047)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1850209420View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for GRACE KIM HARRIS (DO)?
GRACE KIM HARRIS (DO) — NPI 1093725277 — is the standard way to identify this listing.
Does the file indicate GRACE KIM HARRIS (DO) is practicing under active NPI?
Directory data currently reports GRACE KIM HARRIS (DO) as active.
What is GRACE KIM HARRIS (DO) best known for clinically?
Directory data describes GRACE KIM HARRIS (DO) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What address line appears for GRACE KIM HARRIS (DO)?
GRACE KIM HARRIS (DO)'s geographic hint is Midvale, Utah in our summary view.
Why does GRACE KIM HARRIS (DO) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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