KENNETH LYNN JR. HOLT (PA-C) – Physician Assistant, NPI 1467180463
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
1,971 PHYSICIAN ASSISTANT in UT
Provider Addresses for KENNETH LYNN JR. HOLT (PA-C)
941 E 3300 S
Millcreek, UT 841062140
Phone: (801) 266-3700
Type: Location
50 N Medical Dr
Salt Lake City, UT 841325644
Phone: (801) 581-2121
Type: Location
759 E 13800 S
DRAPER, UT 840209735
Phone:
Type: Mailing
122 E 1700 S BLDG 1
PROVO, UT 846065644
Phone: (801) 375-5125
Type: Location
4184 HILLTOP CT
PARK CITY, UT 840984715
Phone:
Type: Mailing
2000 CIRCLE OF HOPE DR
SALT LAKE CITY, UT 841125550
Phone: (801) 587-7000
Type: Location
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: 2024-04-10
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240410001089 | I | Physician Assistant | UT | TBD |
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.
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 84106)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | UT | |
| - | UT | |
| Emergency Medicine | CO | |
| - | UT | |
| A N E S T H E S I O L O G Y | UT | |
| Physician Assistant | UT | |
| - | IL | |
| Plastic And Reconstructive Surgery | OH | |
| Physician Assistant | CA | |
| A N E S T H E S I O L O G Y | UT |
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