Active NPI
Nicole Stapley, DNP
- Pediatric Nurse Practitioner
- Kaysville, UT
National Provider Identifier
1063898377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 7627343-4405
- Practice address
- 380 N 400 W
Kaysville, UT 84037-3135 - Phone
- (801) 773-4840
- Fax
- (801) 525-8151
- NPI assigned
- Aug 10, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 7627343-4405 | UT | Primary |
Addresses
Primary practice location
380 N 400 W
Kaysville, UT 84037-3135
Mailing address
PO Box 337
Layton, UT 84041-0337
Phone (801) 773-4840
Other names 1
- Nicole Rodgers
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tanner Memorial Clinic | Pediatrics | Current | Accepting new patients |
| Tanner Memorial Clinic | Current | Accepting new patients |
Locations
380 N 400 W
Kaysville, UT 84037
Phone (801) 547-9500
425 S 100 W
Layton, UT 84041
Phone (801) 682-8708
Networks
- UT PPO D-SNP
- UT PPO
Interoperability endpoints
- nicole.stapley.p1@direct.tannerclinic.nextgenshare.com
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.
-
dba Tanner Clinic Layton South
- Multi-Specialty Clinic/Center
- Layton, UT
- NPI 1538951165
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439164800000",
"number": "1063898377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 337",
"city": "LAYTON",
"state": "UT",
"postal_code": "840410337",
"telephone_number": "801-773-4840",
"fax_number": "801-525-8151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "380 N 400 W",
"city": "KAYSVILLE",
"state": "UT",
"postal_code": "840373135",
"telephone_number": "801-773-4840",
"fax_number": "801-525-8151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAPLEY",
"first_name": "NICOLE",
"credential": "DNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-10",
"last_updated": "2015-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "UT",
"license": "7627343-4405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NICOLE",
"last_name": "RODGERS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Kaysville, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.