Individual provider Active NPI

Kristina Tiffany McMahon, APRN, FNP-C

  • Family Nurse Practitioner
  • St George, UT
National Provider Identifier
1053600171
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
372279-4405 Issued in UT
Practice address
1173 S 250 W
Suite 101
St George, UT 84770-6392
Phone
(435) 619-0519
NPI assigned
Mar 29, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 372279-4405 UT Primary

Addresses

Primary practice location

1173 S 250 W
Suite 101
St George, UT 84770-6392

Mailing address

30 E 200 N
La Verkin, UT 84745-5304
Phone (435) 619-0519

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110915000698 UT Practitioner - Nurse Practitioner 9931370384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Surgical Associates IncGroup PAC ID 4486686698, 48 clinicians

Practice addresses (Care Compare)

1490 E Foremaster Dr
Suite 200
Saint George, UT 84790-4496
Phone (435) 628-1641

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
372279-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Surgical Associates, Inc. CurrentSince Oct 6, 2014 Accepting new patients
Utah Surgical Associates Surgery Past Accepting new patients

Locations

3550 N University Ave
Ste 250
Provo, UT 84604
Phone (801) 374-9625

1490 E Foremaster Dr
Ste 200
St George, UT 84790
Phone (435) 528-1641

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1053600171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E 200 N",
            "city": "LA VERKIN",
            "state": "UT",
            "postal_code": "847455304",
            "telephone_number": "435-619-0519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1173 S 250 W",
            "address_2": "SUITE 101",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847706392",
            "telephone_number": "435-619-0519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHON",
        "first_name": "KRISTINA",
        "middle_name": "TIFFANY",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-29",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "372279-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.