Individual provider Active NPI

Andrea Walkenhorst, DNP

  • Acute Care Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1306121132
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
350691-4405 Issued in UT
Practice address
1160 E 3900 S
#3500
Salt Lake City, UT 84124-1202
Phone
(801) 743-4750
Fax
(801) 743-4765
NPI assigned
Oct 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 350691-4405 UT Primary

Addresses

Primary practice location

1160 E 3900 S
#3500
Salt Lake City, UT 84124-1202

Mailing address

1160 E 3900 S
#3500
Salt Lake City, UT 84124-1202
Phone (801) 743-4750

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address awalkenhorst2986@epicmtn.hcadirect.net

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
I20121115000461 UT Practitioner - Nurse Practitioner 0143471391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
76.69 of 100Reported as group
Quality
50.27
Improvement activities
40
Cost
55.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
350691-4405UTMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gadzoom Health LLC CurrentSince Feb 19, 2024 Accepting new patients
Careconnectmd Utah PC CurrentSince Feb 1, 2025 Accepting new patients
Mountainstar Cardiology St Marks LLC PastSince Feb 6, 2022 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

6975 S Union Park Ctr
Fl 6
Cottonwood Heights, UT 84047

13894 S Bangerter Pkwy
Ste 200
Draper, UT 84020
Phone (208) 996-3519

3401 N Thanksgiving Way
Ste 190
Lehi, UT 84048
Phone (385) 454-5027

Networks

  • UT PPO

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1306121132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 E 3900 S",
            "address_2": "#3500",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241202",
            "telephone_number": "801-743-4750",
            "fax_number": "801-743-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 E 3900 S",
            "address_2": "#3500",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241202",
            "telephone_number": "801-743-4750",
            "fax_number": "801-743-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKENHORST",
        "first_name": "ANDREA",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-12",
        "last_updated": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "UT",
            "license": "350691-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awalkenhorst2986@epicmtn.hcadirect.net",
            "affiliation": "N",
            "address_1": "1160 E 3900 S",
            "address_2": "#3500",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841241202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.