Individual provider Active NPI

Kristi Lynn Adamson Kissell, APRN

  • Acute Care Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1346656212
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
368753-8900 Issued in UT
Practice address
500 Foothill Dr
Salt Lake City, UT 84148-0001
Phone
(801) 528-1565
NPI assigned
Jul 10, 2014
Last updated
Feb 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 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 368753-8900 UT Primary

Addresses

Primary practice location

500 Foothill Dr
Salt Lake City, UT 84148-0001

Mailing address

500 Foothill Dr
Salt Lake City, UT 84148-0001
Phone (801) 582-1565

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kkissell40958@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
I20161122002217 UT Practitioner - Nurse Practitioner 7416248547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountainstar Cardiovascular Services LLCGroup PAC ID 1951404110, 14 clinicians

Practice addresses (Care Compare)

1160 E 3900
Suite 3500
Salt Lake City, UT 84124-1264
Phone (801) 743-4750

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
368753-8900UTMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mountainstar Cardiovascular Services LLC CurrentSince Sep 1, 2017 Accepting new patients
Mountainstar Cardiology St Marks LLC PastSince Sep 1, 2017 Accepting new patients

Locations

1160 E 3900 S
Ste 3500
Salt Lake Cty, UT 84124
Phone (801) 476-6900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1346656212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 FOOTHILL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841480001",
            "telephone_number": "801-582-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FOOTHILL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841480001",
            "telephone_number": "801-528-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSELL",
        "first_name": "KRISTI",
        "middle_name": "LYNN ADAMSON",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-10",
        "last_updated": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "UT",
            "license": "368753-8900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkissell40958@epicmtn.hcadirect.net",
            "affiliation": "N",
            "address_1": "500 Foothill Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841480001",
            "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.