Kimberly Kae Weggemann Holder, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5039306-4405 Issued in UT

Practice address

3018 E 3300 S
Salt Lake City, UT 84109-2144

Phone

(801) 419-0705

NPI assigned

Aug 13, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Kae Weggemann Professional name

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Valdar LLCGroup PAC ID 8123360534, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IDJJDD/Endpoint/IDJJDD

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.

• Valdar LLC

  • Family Nurse Practitioner
  • Bountiful, UT
  • NPI 1336619675
  Medicare reassignment Care Compare group NPD
• Virtare Health Physician Services of Utah PLLC

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1164286761
  Medicare reassignment NPD
• Top Medical Now LLC

  • Family Medicine Physician
  • Bountiful, UT
  • NPI 1982308425
  NPD
• C and B Family Practice LLC

  • Nurse Practitioner
  • Altonah, UT
  • NPI 1841825213
  NPD (past)
• Frogley Holding LLC

  • Chiropractor
  • Bountiful, UT
  • NPI 1376735795
  NPD (past)
• BL Anderson Medical Corporation

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1821627639
  NPD (past)

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

• St Lukes Regional Medical Center

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1124674460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10890 THORNMINT RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921272402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3018 E 3300 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841092144",
            "telephone_number": "801-419-0705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4001 S 700 E Ste 500",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841072523",
            "country_code": "US",
            "telephone_number": "855-745-8400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10890 Thornmint Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921272402",
            "country_code": "US",
            "telephone_number": "855-745-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEGGEMANN HOLDER",
        "first_name": "KIMBERLY",
        "middle_name": "KAE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-13",
        "last_updated": "2024-05-08",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "5039306-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "WEGGEMANN",
            "middle_name": "KAE",
            "credential": "FNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Deanna F Weeks
• Claire E Weems Shaffer
• Melia Shelton Wegelin, PA
• Laura Elizabeth Wegener, CSW
• William Brian Wegesser, PA-C
• Lauren Ashley Wegrowski, DNP, APRN, CPNP-PC
• Jennifer Wehan
• Chris K Wehl, PH.D.
• Caryn Delayn Wehmeyer
• Jen-Yu Wei, D.O

• Family Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.

Verify at the official NPI Registry.