Individual provider Active NPI

Elizabeth Mary Katomski, R.N.

  • Psychiatric/Mental Health Registered Nurse
  • Salt Lake City, UT
National Provider Identifier
1053302406
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
2759003102 Issued in UT
Practice address
550 W 700 S
Salt Lake City, UT 84101-2227
Phone
(801) 537-7537
Fax
(801) 363-3140
NPI assigned
Nov 3, 2005
Last updated
Mar 17, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 2759003102 UT Primary

Addresses

Primary practice location

550 W 700 S
Salt Lake City, UT 84101-2227

Mailing address

1661 Blaine Ave
Salt Lake City, UT 84105-3802
Phone (801) 486-6330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2759003102UTMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Mental Health Incorporated Past Accepting new patients
Valley Behavioral Health Incorporated Psychiatric/Mental Health Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1053302406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 BLAINE AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053802",
            "telephone_number": "801-486-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W 700 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841012227",
            "telephone_number": "801-537-7537",
            "fax_number": "801-363-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATOMSKI",
        "first_name": "ELIZABETH",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-03",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "UT",
            "license": "2759003102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.