Individual provider Active NPI

Samantha Whitehead, FNP-BC

  • Primary Care Nurse Practitioner
  • Saratoga Springs, UT
National Provider Identifier
1417526864
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
5942923-4405 Issued in UT
Practice address
41 E 1140 N Ste B
Saratoga Springs, UT 84045-5467
Phone
(801) 407-6500
NPI assigned
Jun 21, 2021
Last updated
Aug 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 5942923-3102 UT
Primary Care Nurse Practitioner 363LP2300X 5942923-4405 UT Primary

Addresses

Primary practice location

41 E 1140 N Ste B
Saratoga Springs, UT 84045-5467

Mailing address

41 E 1140 N Ste B
Saratoga Springs, UT 84045-5467
Phone (801) 407-6500

Other names 1

  • Samantha Crismon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5942923-3102UTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Valley Pediatrics L.L.C. CurrentSince Aug 17, 2025 Accepting new patients
Utah Valley Pediatrics L.L.C. PastSince Aug 17, 2025 Accepting new patients

Locations

41 E 1140 N
Ste B
Saratoga Springs, UT 84045
Phone (801) 407-6500

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.

NPI Registry JSON

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1417526864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 E 1140 N STE B",
            "city": "SARATOGA SPRINGS",
            "state": "UT",
            "postal_code": "840455467",
            "telephone_number": "801-407-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 E 1140 N STE B",
            "city": "SARATOGA SPRINGS",
            "state": "UT",
            "postal_code": "840455467",
            "telephone_number": "801-407-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "SAMANTHA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "5942923-3102",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "UT",
            "license": "5942923-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "CRISMON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saratoga Springs, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.