Individual provider Active NPI

Kathryn Melissa Nelson, DO

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Layton, UT
National Provider Identifier
1225567803
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
12974427-1204 Issued in UT
Practice address
2075 University Park Blvd
Layton, UT 84041-1611
Phone
(801) 779-6200
NPI assigned
Jun 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 12974427-1204 UT
Student in an Organized Health Care Education/Training Program 390200000X
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 12974427-1204 UT Primary

Addresses

Primary practice location

2075 University Park Blvd
Layton, UT 84041-1611

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

7031 SW 62nd Ave
South Miami, FL 33143-4701
Phone (305) 824-4719

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221101001242 UT Practitioner - Pain ManagementPractitioner - Interventional Pain Management 3678940897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Interventional Pain Management
Education
Arizona College of Osteopathic Medicine Mid Western University, 2017
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)

2075 University Park Blvd
Layton, UT 84041-1611
Phone (801) 779-6300

Hospital & facility affiliations

  • Intermountain Health Layton Hospital Hospital, Layton, UT, CCN 460061
  • Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
12974427-1204UTMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Oct 2, 2022 Accepting new patients
Ihc Health Services Inc CurrentSince Oct 2, 2022 Accepting new patients
Ihc Health Services Inc Past 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

2075 University Park Blvd
#1
Layton, UT 84041

9450 S 1300 E
Ste 120
Sandy, UT 84094
Phone (801) 501-5500

Organizations & group practices 4

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 2

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": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1225567803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 UNIVERSITY PARK BLVD",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840411611",
            "telephone_number": "801-779-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7031 SW 62nd Ave",
            "address_purpose": "LOCATION",
            "city": "South Miami",
            "state": "FL",
            "postal_code": "331434701",
            "country_code": "US",
            "telephone_number": "305-824-4719",
            "fax_number": "305-284-7577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KATHRYN",
        "middle_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "UT",
            "license": "12974427-1204",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "UT",
            "license": "12974427-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.