NPIMap

Individual provider Active NPI

Kathleen M Stahl, NP

  • Family Nurse Practitioner
  • St George, UT
National Provider Identifier
1053625541
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
374568-4408 Issued in UT
Practice address
652 S Medical Center Dr Ste 110
St George, UT 84790-7077
Phone
(435) 787-8146
Fax
(435) 787-8149
NPI assigned
Jul 27, 2010
Last updated
Nov 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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 374568-4408 UT Primary

Addresses

Primary practice location

652 S Medical Center Dr Ste 110
St George, UT 84790-7077

Mailing address

630 E 1400 N Ste 135
Logan, UT 84341-2549
Phone (435) 787-8146

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kstahl368165@direct.med.utah.edu Health Information Exchange (HIE) University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101206001272 UT Practitioner - Nurse Practitioner 1658568480 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
Telehealth
Offers telehealth services
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

1950 Circle of Hope Dr
Salt Lake City, UT 84112-5500
Phone (801) 581-8793

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
374568-4408UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Aug 25, 2019 Accepting new patients
University of Utah Adult Services CurrentSince Aug 25, 2019 Accepting new patients

Locations

1950 Circle of Hope Dr
Slc, UT 84112
Phone (801) 585-0100

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Interoperability endpoints

  • Direct secure messaging: kstahl368165@direct.med.utah.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1053625541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 E 1400 N STE 135",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412549",
            "telephone_number": "435-787-8146",
            "fax_number": "435-787-8149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 S MEDICAL CENTER DR STE 110",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847907077",
            "telephone_number": "435-787-8146",
            "fax_number": "435-787-8149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHL",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-27",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "374568-4408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kstahl368165@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.