Individual provider Active NPI

Tara Hull, FNP-C

  • Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1306646211
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10681833-4405 Issued in UT
Practice address
2830 S Beverly St
Salt Lake City, UT 84106-3170
Phone
(912) 506-8486
NPI assigned
Mar 18, 2025
Last updated
Mar 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10681833-4405 UT Primary

Addresses

Primary practice location

2830 S Beverly St
Salt Lake City, UT 84106-3170

Mailing address

2830 S Beverly St
Salt Lake City, UT 84106-3170
Phone (912) 506-8486

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
I20250919003107 UT Practitioner - Nurse Practitioner 8022512136 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
Green River Radiology PCGroup PAC ID 5294123063, 23 clinicians

Practice addresses (Care Compare)

1982 W Pleasant Grove Blvd
Suite L
Pleasant Grove, UT 84062-3268
Phone (801) 563-0333

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Green River Radiology, P.C. CurrentSince Jul 20, 2025 Accepting new patients

Locations

5775 Wayzata Blvd
Ste 400
St Louis Park, MN 55416
Phone (952) 525-6338

1982 W Pleasant Grove Blvd
Ste L
Pleasant Grv, UT 84062
Phone (801) 563-0333

12842 S 3600 W
Ste 100
Riverton, UT 84065
Phone (385) 253-4586

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1306646211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 S BEVERLY ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063170",
            "telephone_number": "912-506-8486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 S BEVERLY ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063170",
            "telephone_number": "912-506-8486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULL",
        "first_name": "TARA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "10681833-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.