Individual provider Active NPI

Kira Waters, CNM, WHNP

  • Advanced Practice Midwife
  • Salt Lake City, UT
National Provider Identifier
1396118956
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
8459364-4402 Issued in UT
Practice address
1140 E 3900 S Ste 400
Salt Lake City, UT 84124-1269
Phone
(801) 268-6811
NPI assigned
Nov 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 8459364-4402 UT Primary

Addresses

Primary practice location

1140 E 3900 S Ste 400
Salt Lake City, UT 84124-1269

Mailing address

PO Box 198546
Atlanta, GA 30384-8546

Other practice location 1

1151 E 3900 S
Salt Lake City, UT 84124-1216
Phone (801) 685-7188

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180320002483 UT Practitioner - Certified Nurse Midwife (CNM) 8325300973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Mark'S Gynecology Oncology Care LLCGroup PAC ID 4486736279, 17 clinicians

Practice addresses (Care Compare)

1140 E 3900
Suite 400
Salt Lake City, UT 84124-1269
Phone (801) 268-6811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
8459364-4402UTMDAdvanced Practice Midwife

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1396118956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198546",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 E 3900 S STE 400",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241269",
            "telephone_number": "801-268-6811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1151 E 3900 S",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841241216",
            "country_code": "US",
            "telephone_number": "801-685-7188",
            "fax_number": "801-685-8116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATERS",
        "first_name": "KIRA",
        "credential": "CNM, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "UT",
            "license": "8459364-4402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.