Active NPI
Karen Checketts, PH.D.
- Psychologist
- Sandy, UT
National Provider Identifier
1114336617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 5080319-2501
- Practice address
- 9035 S 1300 E
B120
Sandy, UT 84094-3132 - Phone
- (801) 838-7606
- NPI assigned
- Aug 8, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 5080319-2501 | UT | |
| Psychologist | 103T00000X | 5080319-2501 | UT | Primary |
| Psychiatry Physician | 2084P0800X | 5080319-2501 | UT |
Addresses
Primary practice location
9035 S 1300 E
B120
Sandy, UT 84094-3132
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Other practice location 1
292 S 1470 E
St George, UT 84790-1763
Phone (435) 251-5900
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Bluemark LLC/ Office Ally |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY, UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
320 E 600
St George, UT 84770-3949
Phone (435) 688-4850
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5080319-2501 | UT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Wyoming | Current | Accepting new patients | |
| State of Wyoming | Current | Accepting new patients | |
| Advanced Psychological Services | Psychologist | Past | Accepting new patients |
Locations
831 Highway 150 S
Evanston, WY 82930
Phone (307) 444-0839
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Sandy, UT
- NPI 1942325154
-
- Psychiatric Hospital
- Evanston, WY
- NPI 1316011562
-
- Psychologist
- Sandy, UT
- NPI 1306119441
-
- Skilled Nursing Facility
- Buffalo, WY
- NPI 1386396935
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775174400000",
"number": "1114336617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27128",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841270128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9035 S 1300 E",
"address_2": "B120",
"city": "SANDY",
"state": "UT",
"postal_code": "840943132",
"telephone_number": "801-838-7606"
}
],
"practiceLocations": [
{
"address_1": "292 S 1470 E",
"address_purpose": "LOCATION",
"city": "St George",
"state": "UT",
"postal_code": "847901763",
"country_code": "US",
"telephone_number": "435-251-5900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHECKETTS",
"first_name": "KAREN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-08",
"last_updated": "2026-04-03",
"certification_date": "2026-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "UT",
"license": "5080319-2501",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "UT",
"license": "5080319-2501",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "UT",
"license": "5080319-2501",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.2019.3",
"affiliationName": "Bluemark LLC/ Office Ally",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CMS esMD eMDR",
"address_1": "1300 SE Cardinal Ct Ste 190",
"city": "Vancouver",
"state": "WA",
"country_code": "US",
"postal_code": "986839683",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Sandy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.