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KELLY W HUBBARD MD PC
NPI 1770779985
Dermatology in Logan, UT

Active since September 20, 2007CLIA Certified · 2 labs
2380 N 400 E, STE B, LOGAN, UT 84341(435) 752-5741 Get Directions Write a Review

NPPES record last updated: November 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kelly W Hubbard Md Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY W HUBBARD MD PC (NPI 1770779985) is a healthcare organization registered as a dermatology in Logan, Utah and active in the NPI registry since September 2007. The organization holds 2 active CLIA laboratory certificates and lists Tracey Kartsone, Accounts Manager, as its authorized official.

NPPES Registry Identity

NPI1770779985
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameKELLY W HUBBARD MD PC
Location Address2380 N 400 E, STE BLogan, UT 84341-1749
Mailing Address274 N Main StLogan, UT 84321-3915 · (435) 753-1600 · Fax (435) 753-9521
Phone(435) 752-5741
Organization SubpartNo
Authorized OfficialTracey KartsoneAccounts Manager · (435) 753-1600
Enumeration DateSeptember 20, 2007
Last NPPES UpdateNovember 8, 2007
✔ NPI 1770779985 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in UT · 3085198-1205
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Also ListedDermatology · Clinical & Laboratory Dermatological ImmunologyTaxonomy 207NI0002X · License 3085198-1205 (UT)
Also ListedDermatology · Pediatric DermatologyTaxonomy 207NP0225X · License 3085198-1208 (UT)
Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X · License 3085198-1205 (UT)
2380 N 400 E, Logan, UT 84341
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 46D0524801

Kelly W Hubbard MD Cache Valley Dermatology · North Logan, UT
Active · expires Jul 10, 2028
CLIA Number46D0524801
Laboratory TypePhysician Office
Certificate Effective DateJuly 11, 2026
Certificate Expiration DateJuly 10, 2028
Laboratory DirectorKelly W. Hubbard
Laboratory Phone(435) 752-5741
Laboratory LocationKelly W Hubbard MD Cache Valley Dermatology2245 N 400 E, Ste 104, North Logan, UT 84341
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 46D2175159

Kelly Hubbard, Md-Cache Valley Dermatology · Providence, UT
Active · expires Nov 17, 2027
CLIA Number46D2175159
Laboratory TypePhysician Office
Certificate Effective DateNovember 18, 2025
Certificate Expiration DateNovember 17, 2027
Laboratory DirectorKelly W. Hubbard
Laboratory Phone(435) 752-5741
Laboratory LocationKelly Hubbard, Md-Cache Valley Dermatology530 W 465 N, Suite 701, Providence, UT 84332
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NINA G JORGENSEN M.D.
Pediatrics
2380 N 400 E, STE C
NORTH LOGAN, UT 84341
Cache County (435) 753-7337
INTERWEST COMPREHENSIVE PAIN CENTER
Anesthesiology (Pain Medicine)
2380 N 400 E, STE A
LOGAN, UT 84341
Cache County (435) 713-9681
THOMAS L REES PT
Physical Therapist
2380 N 400 E
LOGAN, UT 84341
Cache County (435) 713-9700
PHIL RICH INC
Pharmacy (Long Term Care Pharmacy)
2380 N 400 E, E2
NORTH LOGAN, UT 84341
Cache County (435) 787-1212
WOOD WOUND CARE, LLC
Surgery
2380 N 400 E, SUITE H
NORTH LOGAN, UT 84341
Cache County (435) 713-1350
ASHLEY ANNE CRUM
Emergency Medicine
2380 N 400 E
NORTH LOGAN, UT 84341
Cache County (435) 713-9700
RYAN J GREEN PT
Physical Therapist
2380 N 400 E
LOGAN, UT 84341
Cache County (435) 713-9710
ROGER A OLSON
Physical Therapist
2380 N 400 E
LOGAN, UT 84341
Cache County (435) 713-9700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly W Hubbard MD PC's NPI number?

The NPI number for Kelly W Hubbard MD PC is 1770779985. It was assigned to this organization in the NPPES registry on September 20, 2007.

Where is Kelly W Hubbard MD PC located?

Kelly W Hubbard MD PC is located at 2380 N 400 E Ste B, Logan, UT 84341. The listed phone number is (435) 752-5741.

What is Kelly W Hubbard MD PC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Kelly W Hubbard MD PC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Kelly W Hubbard MD PC accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and University of Utah Health Plans list Kelly W Hubbard MD PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelly W Hubbard MD PC was last updated on November 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.