Individual provider Active NPI

Trent Kenworthy, FNP-C

  • Dermatology Physician
  • St George, UT
National Provider Identifier
1407321722
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
7858417-4405 Issued in UT
Practice address
230 N 1680 E Ste N
St George, UT 84790-2579
Phone
(435) 680-3376
NPI assigned
Oct 13, 2018
Last updated
Mar 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7858417-4405 UT
Dermatology Physician 207N00000X 7858417-4405 UT Primary

Addresses

Primary practice location

230 N 1680 E Ste N
St George, UT 84790-2579

Mailing address

230 N 1680 E Ste N
St George, UT 84790-2579
Phone (435) 680-3376

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
I20190429001247 UT Practitioner - Nurse Practitioner 3971845637 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acuity Wound CareGroup PAC ID 4688108814, 6 clinicians
Bridge Clinic, PLLCGroup PAC ID 4981136967, 2 clinicians

Practice addresses (Care Compare)

1460 N Main St
Unit 1B
Spanish Fork, UT 84660-1016
Phone (385) 518-0403

230 N 1680
Suite N1
St George, UT 84790-2596
Phone (435) 680-3376

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7858417-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bridge Clinic, PLLC Dermatology CurrentSince Aug 1, 2024 Accepting new patients
Acuity Wound Care Family CurrentSince May 1, 2025 Accepting new patients
Huntsman West Spine LLC PastSince Dec 10, 2013 Accepting new patients

Locations

1460 N Main St
Unit 1B
Spanish Fork, UT 84660
Phone (801) 318-8930

230 N 1680 E
Ste N1
St George, UT 84790
Phone (435) 313-7237

Interoperability endpoints

  • Direct secure messaging: trent.kenworthy@486851367337988.direct.elationemr.com

Organizations & group practices 3

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": "1539388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1407321722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N 1680 E STE N",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847902579",
            "telephone_number": "435-680-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N 1680 E STE N",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847902579",
            "telephone_number": "435-680-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENWORTHY",
        "first_name": "TRENT",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-13",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "7858417-4405",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "UT",
            "license": "7858417-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.