Individual provider Active NPI

Susan Hilderbrand, R.N.

  • Pediatric Registered Nurse
  • Richfield, UT
National Provider Identifier
1174949416
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
3291663102 Issued in UT
Practice address
70 W Westview Dr
Richfield, UT 84701-1868
Phone
(435) 896-5451
Fax
(435) 896-4353
NPI assigned
Mar 11, 2014
Last updated
Mar 11, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 3291663102 UT Primary

Addresses

Primary practice location

70 W Westview Dr
Richfield, UT 84701-1868

Mailing address

70 W Westview Dr
Richfield, UT 84701-1868
Phone (435) 896-5451

Other identifiers 1

IdentifierTypeStateIssuer
998877683003MedicaidUT

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
3291663102UTMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1394496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1174949416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 W WESTVIEW DR",
            "city": "RICHFIELD",
            "state": "UT",
            "postal_code": "847011868",
            "telephone_number": "435-896-5451",
            "fax_number": "435-896-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 W WESTVIEW DR",
            "city": "RICHFIELD",
            "state": "UT",
            "postal_code": "847011868",
            "telephone_number": "435-896-5451",
            "fax_number": "435-896-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILDERBRAND",
        "first_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-11",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "UT",
            "license": "3291663102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "998877683003",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.