Kimberly A Spangrude, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

223145-4405 Issued in UT

Practice address

3354 E Rutland PL
Cottonwood Heights, UT 84121-5829

Phone

(801) 971-1739

NPI assigned

Mar 15, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16255/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Midvale Family Health Clinic Inc

  • Primary Care Clinic/Center
  • Midvale, UT
  • NPI 1497702112
  NPD (past) Authorized official
• Physician Group of Utah Inc

  • Specialist
  • South Jordan, UT
  • NPI 1477676930
  NPD (past)
• Revere Health PC

  • Multi-Specialty Clinic/Center
  • Spanish Fork, UT
  • NPI 1851142285
  NPD (past)
• Western Neurological Associates Inc

  • Neurology Physician
  • Salt Lake City, UT
  • NPI 1083611966
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1013986710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 E. MAIN ST.",
            "address_2": "BUSINESS OPTIONS MEDICAL BILLING",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814013831",
            "telephone_number": "970-765-0810",
            "fax_number": "970-497-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3354 E RUTLAND PL",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841215829",
            "telephone_number": "801-971-1739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "61492 Niagara Rd",
            "address_purpose": "LOCATION",
            "city": "Montrose",
            "state": "CO",
            "postal_code": "814039606",
            "country_code": "US",
            "telephone_number": "801-971-1739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPANGRUDE",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-APN.0991964-C-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "223145-4405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B FOR LBN: OLATHE COMMUNITY CLINIC",
            "identifier": "451870YS6E",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Cottonwood Heights, UT
• Providers in Cottonwood Heights, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.