Individual provider Active NPI

Kristie Sue Julien, D.O.

  • Psychiatry Physician
  • Bountiful, UT
National Provider Identifier
1376740787
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
7738449-1204 Issued in UT
Practice address
282 Lago Vista Cir
Bountiful, UT 84010-1821
Phone
(801) 678-1083
NPI assigned
Jun 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 7738449-1204 UT Primary
Child & Adolescent Psychiatry Physician 2084P0804X 7738449-1204 UT

Addresses

Primary practice location

282 Lago Vista Cir
Bountiful, UT 84010-1821

Mailing address

282 Lago Vista Cir
Bountiful, UT 84010-1821
Phone (801) 678-1083

Other identifiers 1

IdentifierTypeStateIssuer
R1100OtherAZTRAINING LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20140604001042 AZ Practitioner - Psychiatry 6800019290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.7 of 100Reported as group
Quality
64.97
Promoting interoperability
98
Improvement activities
40
Cost
69.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7738449-1204UTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Jan 15, 2014 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Jan 15, 2014 Accepting new patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Banner Behavioral Health Hospital Past Accepting new patients

Locations

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

7575 E Earll Dr
Scottsdale, AZ 85251
Phone (480) 448-7500

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.

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384473600000",
    "number": "1376740787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 LAGO VISTA CIR",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840101821",
            "telephone_number": "801-678-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 LAGO VISTA CIR",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840101821",
            "telephone_number": "801-678-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JULIEN",
        "first_name": "KRISTIE",
        "middle_name": "SUE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2013-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "7738449-1204",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "UT",
            "license": "7738449-1204",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINING LICENSE",
            "identifier": "R1100",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

Verify at the official NPI Registry.