Individual provider Active NPI

McKenzie Stauffer

  • Family Nurse Practitioner
  • West Valley City, UT
National Provider Identifier
1215627765
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11334486-4405 Issued in UT
Practice address
2830 S Redwood Rd
West Valley City, UT 84119-5625
Phone
(801) 233-6100
NPI assigned
May 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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 11334486-4405 UT Primary

Addresses

Primary practice location

2830 S Redwood Rd
West Valley City, UT 84119-5625

Mailing address

8043 S Mill Grove LN
Midvale, UT 84070-2915
Phone (801) 664-2513

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
I20241002002910 UT Practitioner - Nurse Practitioner 9931630829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CNS Professional ServicesGroup PAC ID 4486826294, 2 clinicians

Practice addresses (Care Compare)

2830 S Redwood Rd
West Valley City, UT 84119-5625
Phone (801) 233-6100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11334486-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CNS Professional Services CurrentSince Mar 16, 2025 Accepting new patients
CNS Professional Services CurrentSince Mar 16, 2025 Accepting new patients

Locations

2830 S Redwood Rd
West Valley City, UT 84119
Phone (801) 233-6100

Organizations & group practices 2

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": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1215627765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8043 S MILL GROVE LN",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840702915",
            "telephone_number": "801-664-2513",
            "fax_number": "888-713-8332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 S REDWOOD RD",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841195625",
            "telephone_number": "801-233-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUFFER",
        "first_name": "MCKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-09",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "11334486-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley City, UT

Sources for this page

Verify at the official NPI Registry.