Individual provider Active NPI

Sarah Jean Kidde, CNM

  • Midwife
  • Salt Lake City, UT
National Provider Identifier
1063677276
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
5935921-4402 Issued in UT
Practice address
10 S 2000 E
Salt Lake City, UT 84112-5880
Phone
(801) 581-4014
NPI assigned
Jul 28, 2008
Last updated
Dec 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 5935921-4402 UT Primary

Addresses

Primary practice location

10 S 2000 E
Salt Lake City, UT 84112-5880

Mailing address

1371 E Gilmer Dr
Salt Lake City, UT 84105-1602
Phone (801) 913-1030

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141106000028 UT Practitioner - Certified Nurse Midwife (CNM) 1557420403 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
5935921-4402UTMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Nov 10, 2018 Accepting new patients
Ihc Health Services Inc CurrentSince Nov 10, 2018 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

201 W Layton Pkwy
Ste 2B
Layton, UT 84041
Phone (801) 543-6850

5121 S Cottonwood St
Ste 170
Salt Lake City, UT 84107
Phone (801) 507-7070

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

Organizations & group practices 4

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": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1063677276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 E GILMER DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841051602",
            "telephone_number": "801-913-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 S 2000 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125880",
            "telephone_number": "801-581-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDDE",
        "first_name": "SARAH",
        "middle_name": "JEAN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "UT",
            "license": "5935921-4402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.