Individual provider Active NPI

Kelsey Rose Janusch, NP-C

  • Family Nurse Practitioner
  • Park City, UT
National Provider Identifier
1124798749
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8391784-4405 Issued in UT
Practice address
1784 Uinta Way Unit E2
Park City, UT 84098-7685
Phone
(435) 604-0160
NPI assigned
Sep 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8391784-4405 UT Primary

Addresses

Primary practice location

1784 Uinta Way Unit E2
Park City, UT 84098-7685

Mailing address

2222 Tremper CT
Park City, UT 84060-1241
Phone (415) 497-8823

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
I20220519002819 UT Practitioner - Nurse Practitioner 9133526833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1750 Sidewater Dr
Park City, UT 84060-7570
Phone (435) 649-7640

454 E Medical Way
Heber City, UT 84032-1391
Phone (435) 654-2500

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

Hospital & facility affiliations

  • Park City Hospital Hospital, Park City, UT, CCN 460057

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Oct 1, 2021 Accepting new patients
Ihc Health Services, Inc. CurrentSince Oct 1, 2021 Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

12473 S Minuteman Dr
Draper, UT 84020
Phone (801) 495-7900

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

454 E Medical Way
Heber City, UT 84032
Phone (435) 654-2500

6272 S Highland Dr
Murray, UT 84121
Phone (801) 871-6000

390 N Main St
N Salt Lake, UT 84010
Phone (801) 294-1000

1750 Sidewinder Dr
Park City, UT 84060
Phone (435) 649-7640

3723 W 12600 S
Ste 150
Riverton, UT 84065
Phone (801) 285-4560

181 E Medical Tower Dr
Salt Lake City, UT 84107
Phone (801) 314-4266

9450 S 1300 E
Sandy, UT 84094
Phone (801) 501-2133

389 S 900 E
Slc, UT 84102
Phone (385) 282-2000

2655 W 9000 S
West Jordan, UT 84088
Phone (801) 256-6343

5373 W Lake Park Blvd
West Valley City, UT 84120
Phone (801) 902-7940

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": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1124798749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 TREMPER CT",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840601241",
            "telephone_number": "415-497-8823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1784 UINTA WAY UNIT E2",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840987685",
            "telephone_number": "435-604-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANUSCH",
        "first_name": "KELSEY",
        "middle_name": "ROSE",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "8391784-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park City, UT

Sources for this page

Verify at the official NPI Registry.