Individual provider Active NPI

Abigail Smith Mortensen, RN

  • Student in an Organized Health Care Education/Training Program
  • Ogden, UT
National Provider Identifier
1063306975
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
12456160-3102 Issued in UT
Practice address
3875 Stadium Way Dept 3903
Ogden, UT 84408-3903
Phone
(385) 326-7147
NPI assigned
Jun 5, 2025
Last updated
Jun 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 12456160-3102 UT Primary

Addresses

Primary practice location

3875 Stadium Way Dept 3903
Ogden, UT 84408-3903

Mailing address

3781 W 4475 S
West Haven, UT 84401-9612
Phone (385) 326-7147

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
12456160-3102UTMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1749081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1063306975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3781 W 4475 S",
            "city": "WEST HAVEN",
            "state": "UT",
            "postal_code": "844019612",
            "telephone_number": "385-326-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3875 STADIUM WAY DEPT 3903",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844083903",
            "telephone_number": "385-326-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "ABIGAIL",
        "middle_name": "SMITH",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-05",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "UT",
            "license": "12456160-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; 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.