Caitlin Randi Clark, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

12591240-8900 Issued in UT

Practice address

623 E Fort Union Blvd Ste 105
Midvale, UT 84047-5529

Phone

(801) 261-9490

NPI assigned

Aug 22, 2025

Last updated

Sep 24, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mindful Mobile Medicine LLCGroup PAC ID 1254865363, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Refined Healthcare Services LLC Home health agency, Midvale, UT, CCN 467245
• Refined Hospice LLC Hospice, Midvale, UT, CCN 461542

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mindful Mobile Medicine LLC

  • Internal Medicine Physician
  • Midvale, UT
  • NPI 1245068626

  Family

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Refined Home Health and Personal Care LLC

  dba Refined Healthcare Services LLC

  • Home Health Agency
  • Midvale, UT
  • NPI 1588869838
  Care Compare affiliation
• Refined Hospice LLC

  dba Refined Healthcare Services LLC

  • Community Based Hospice Care Agency
  • Midvale, UT
  • NPI 1497720080
  Care Compare affiliation

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

{
    "created_epoch": "1755820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1376421883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 GRANT AVE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844045730",
            "telephone_number": "801-643-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 E FORT UNION BLVD STE 105",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840475529",
            "telephone_number": "801-261-9490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CAITLIN",
        "middle_name": "RANDI",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-22",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "12591240-8900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johanna Isabel Christensen, LCSW
• Kristie Marie Christofferson, LCSW
• Chrysalis Counseling Center, L.L.C.
• Payton Marie Cioffi
• Allison Grace Cirenza
• Kynzie Clark
• Jeffrey W. Cline, MD
• Bridgette Ann Clonts
• Clubhouse Pediatric Dentistry of West Jordan
• Carla Coates, LCSW

• Family Nurse Practitioner in Midvale, UT
• Providers in Midvale, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.