Individual provider Active NPI

Alyssa Kay Klingbeil, AGNP-C, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Ogden, UT
National Provider Identifier
1164888707
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
13430769-4405 Issued in UT
Practice address
3903 Medical Dr Ste 300
Ogden, UT 84403-2317
Phone
(801) 387-5600
NPI assigned
Jan 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X C-APN.0000702-C-NP CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 13430769-4405 UT Primary

Addresses

Primary practice location

3903 Medical Dr Ste 300
Ogden, UT 84403-2317

Mailing address

3903 Medical Dr Ste 300
Ogden, UT 84403-2317

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
I20240103002219 UT Practitioner - Nurse Practitioner 8921399866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

3903 Medical Dr
Suite 300
Ogden, UT 84403-2317
Phone (801) 387-5600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C-APN.0000702-C-NPCOMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Jan 1, 2024 Accepting new patients
Ihc Health Services, Inc. Psychiatry CurrentSince Jan 1, 2024 Accepting new patients
Ihc Health Services Inc Current Accepting new patients

Locations

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

2075 University Park Blvd
Layton, UT 84041
Phone (801) 367-2775

3903 Medical Dr
Ste 300
Ogden, UT 84403
Phone (801) 387-4930

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1452556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1164888707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 MEDICAL DR STE 300",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844032317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 MEDICAL DR STE 300",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844032317",
            "telephone_number": "801-387-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINGBEIL",
        "first_name": "ALYSSA",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "AGNP-C, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-12",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CO",
            "license": "C-APN.0000702-C-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "13430769-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.