Kirk Russell Waldron, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

7301549-8900 Issued in UT

Practice address

770 S 200 E Ste 102
Brigham City, UT 84302-3387

Phone

(801) 513-9652

NPI assigned

Jul 1, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Beecon Recovery IncGroup PAC ID 5799149910, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Beecon Recovery Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Brigham City, UT
  • NPI 1437780673
  Medicare reassignment Care Compare group NPD
• Advantage Medical Center LLC

  • Family Medicine Physician
  • Brigham City, UT
  • NPI 1053861567
  Medicare reassignment NPD
• Valor Medical

  • Family Medicine Physician
  • Ogden, UT
  • NPI 1508600933
  NPD Authorized official
• Whole Mind LLC

  • Psychiatry Physician
  • Pleasant Grove, UT
  • NPI 1659084879
  Medicare reassignment
• Adv Med LLC

  • Family Nurse Practitioner
  • Brigham City, UT
  • NPI 1467152595
  NPD (past)

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1215599105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 S 200 E STE 102",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023387",
            "telephone_number": "801-513-9652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 S 200 E STE 102",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023387",
            "telephone_number": "801-513-9652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDRON",
        "first_name": "KIRK",
        "middle_name": "RUSSELL",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-01",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "7301549-8900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Christopher Vranes, D.C.
• Vyv RX LLC
• W Bryce Cook
• Christopher Aaron Wade, LCSW
• Rebeckah Wade
• Jocee Morrell Walk
• Derrick A Walker, D.O.
• Maria Walton
• Tyler Matthew Walton
• Jordan Wanberg

• Family Nurse Practitioner in Brigham City, UT
• Providers in Brigham 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 Jul 1, 2019; 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.