Kenzlee Wooden

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

9158154-8900 Issued in UT

Practice address

845 S Main St Ste A7
Bountiful, UT 84010-6482

Phone

(801) 298-0903

NPI assigned

Sep 30, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kenzlee Jeppsen Former name

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Freedom Healthcare, LLC

  • General Practice Physician
  • Sandy, UT
  • NPI 1770916306
  Medicare reassignment NPD
• Pinnacle Preventative Health

  • Primary Care Clinic/Center
  • South Ogden, UT
  • NPI 1174376446
  NPD Authorized official
• Taylor G Wright PC

  dba Innovation Medical Group

  • Podiatrist
  • Layton, UT
  • NPI 1528765575
  NPD (past)

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1043851116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5671 S 650 E",
            "city": "WASHINGTON TERRACE",
            "state": "UT",
            "postal_code": "844051201",
            "telephone_number": "801-678-2518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 S MAIN ST STE A7",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106482",
            "telephone_number": "801-298-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODEN",
        "first_name": "KENZLEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "UT",
            "license": "9158154-8900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENZLEE",
            "last_name": "JEPPSEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Berkley Rebecca Wiseman
• Tyler Wiseman, PHARMD
• Tanner Timothy Witte
• Lelajane Wixom, RBT
• Danielle Hillary Wood
• Woodmead Medical Clinic PLLC
• Clint John Wooten, MD
• Holly Wortley
• Alice Fern Wynn, MA
• Jennifer W Wyson, DMD

• Adult Health Nurse Practitioner in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Adult Health Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.