Active NPI
Brenda Mueggenborg, P.N.P.
- Nurse Practitioner
- Salt Lake City, UT
National Provider Identifier
1154371466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 324632-4405
- Practice address
- 50 N Medical Dr
Salt Lake City, UT 84132-0001 - Phone
- (801) 581-2121
- NPI assigned
- May 10, 2006
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 324632-4405 | UT | |
| Pediatric Nurse Practitioner | 363LP0200X | 324632-4405 | UT | |
| Nurse Practitioner | 363L00000X | 324632-4405 | UT | Primary |
Addresses
Primary practice location
50 N Medical Dr
Salt Lake City, UT 84132-0001
Mailing address
PO Box 581700
Salt Lake City, UT 84158-1700
Phone (801) 581-2121
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0437223 | Medicaid | MT | |
| D3855 | Medicaid | UT | |
| QM0000037482 | Other | ALTIUS # | |
| 8101 | Other | UNIVERSITY HEALTH PLANS # | |
| 500019103 | Other | MEDICARE RAILROAD # | |
| 58298 | Other | PEHP # | |
| 887303 | Other | DMBA # | |
| 32463244000001 | Other | REGENCE BCBS OF UTAH # | |
| 806014400 | Medicaid | ID |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bmueggenborg156436@direct.med.utah.edu | Direct | UNIVERSITY OF UTAH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 324632-4405 | UT | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Department of Pediatrics University of Utah | Past | Accepting new patients |
Interoperability endpoints
- bmueggenborg156436@direct.med.utah.edu
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Salt Lake City, UT
- NPI 1679528715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636329600000",
"number": "1154371466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 581700",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841581700",
"telephone_number": "801-581-2121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 N MEDICAL DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841320001",
"telephone_number": "801-581-2121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUEGGENBORG",
"first_name": "BRENDA",
"credential": "P.N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-10",
"last_updated": "2021-11-08",
"certification_date": "2021-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "UT",
"license": "324632-4405",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "UT",
"license": "324632-4405",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "UT",
"license": "324632-4405",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0437223",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D3855",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALTIUS #",
"identifier": "QM0000037482",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERSITY HEALTH PLANS #",
"identifier": "8101",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD #",
"identifier": "500019103",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PEHP #",
"identifier": "58298",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMBA #",
"identifier": "887303",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BCBS OF UTAH #",
"identifier": "32463244000001",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "806014400",
"state": "ID"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bmueggenborg156436@direct.med.utah.edu",
"affiliation": "Y",
"affiliationName": "UNIVERSITY OF UTAH",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.