Individual provider Active NPI

Karen M Waskowicz, NP

  • Nurse Practitioner
  • Murray, UT
National Provider Identifier
1114449576
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10818561-4405 Issued in UT
Practice address
5323 S Woodrow St Ste 203
Murray, UT 84107-5851
Phone
(801) 965-3600
NPI assigned
Jul 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP017639 PA
Nurse Practitioner 363L00000X 10818561-4405 UT Primary

Addresses

Primary practice location

5323 S Woodrow St Ste 203
Murray, UT 84107-5851

Mailing address

2965 W 3500 S
West Valley City, UT 84119-3602
Phone (801) 965-3505

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181019002169 UT Practitioner - Nurse Practitioner 8628340023 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Granger Medical Clinic PCGroup PAC ID 3476465691, 192 clinicians

Practice addresses (Care Compare)

2965 W 3500
West Valley City, UT 84119-3602
Phone (801) 965-3600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP017639PAMDNurse Practitioner
10818561-4405UTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Granger Medical Specialists LLC CurrentSince Nov 1, 2020 Accepting new patients
Granger Medical Specialists, LLC CurrentSince Nov 1, 2020 Accepting new patients
Granger Medical Clinic PC CurrentSince Dec 27, 2023 Accepting new patients

Locations

5323 S Woodrow St
Ste 203
Murray, UT 84107
Phone (801) 266-5559

12391 S 4000 W
Riverton, UT 84096
Phone (801) 302-1700

348 E 4500 S
Salt Lake City, UT 84107
Phone (801) 839-5481

5323 S Woodrow St
Ste 201
Salt Lake City, UT 84107
Phone (801) 261-4711

24 S 1100 E
Ste 105
Salt Lake Cty, UT 84102
Phone (801) 266-3418

995 W Levoy Dr
Taylorsville, UT 84123

7181 S Campus View Dr
Ste 200
West Jordan, UT 84084
Phone (801) 965-3505

7181 S Campus View Dr
West Jordan, UT 84084
Phone (801) 965-3505

3181 W 9000 S
West Jordan, UT 84088
Phone (801) 352-5900

3725 W 4100 S
West Valley City, UT 84120
Phone (801) 965-3545

2965 W 3500 S
West Valley City, UT 84119
Phone (801) 965-3505

Networks

  • UT PPO
  • UT PPO D-SNP

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1114449576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 W 3500 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841193602",
            "telephone_number": "801-965-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 S WOODROW ST STE 203",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075851",
            "telephone_number": "801-965-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASKOWICZ",
        "first_name": "KAREN",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP017639",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "10818561-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.