Kristopher Jon Wentworth

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

F23-109820 Issued in UT

Practice address

285 W 800 S
Roosevelt, UT 84066-3707

Phone

(435) 725-6300

Fax

(435) 725-6325

NPI assigned

Sep 14, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1694649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1063299774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 W 500 S STE 9",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840782912",
            "telephone_number": "435-725-6300",
            "fax_number": "435-725-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 W 800 S",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840663707",
            "telephone_number": "435-725-6300",
            "fax_number": "435-725-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTWORTH",
        "first_name": "KRISTOPHER",
        "middle_name": "JON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-14",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "UT",
            "license": "F23-109820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allen Wallace, CRNA
• Carrie Anne Wallace
• Weston Ross Weaver, RPH
• Jason Allen Weech
• John Spencer Wells, MD
• Jeffrey Lynn Wheeler, D.O.
• Brandon Lee White, D.C.
• James D White, MD
• Ben Douglas Williams, MD
• Jon Preston Wilson, O.D.

• Case Manager/Care Coordinator in Roosevelt, UT
• Providers in Roosevelt, UT by specialty
• Case Manager/Care Coordinator in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.