Kim Sundstrom, DNP, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

8849350-4405 Issued in UT

Practice address

9289 S Redwood Rd Ste C
West Jordan, UT 84088-6731

Phone

(801) 568-2898

NPI assigned

Jul 18, 2024

Last updated

Jul 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

University of Utah School of Medicine, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ksundstrom784782@direct.med.utah.edu

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.

• Canvi Behavioral Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chubbuck, ID
  • NPI 1144984873

  UT

  Medicare reassignment
• DBT Network of Utah

  dba Journeys: Mental Health Services

  • Psychiatric/Mental Health Nurse Practitioner
  • West Jordan, UT
  • NPI 1245897214
  NPD

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1053159624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9289 S REDWOOD RD STE C",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840886731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9289 S REDWOOD RD STE C",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840886731",
            "telephone_number": "801-568-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDSTROM",
        "first_name": "KIM",
        "credential": "DNP, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "8849350-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helen Ann Sullivan, ACMHC
• Jaimie Sullivan
• Josh Sullivan
• Summit Clinical Services of Utah LLC
• Summit View Health Center, LLC
• Sunrise Family Practice LLC
• Sunrise Medical Supply Store
• Racheal Susaeta
• Angela R Sutt, PHARMD
• Taylor S Suval, DC

• Psychiatric/Mental Health Nurse Practitioner in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.