Active NPI
Kaitlynn Ellis
- Physician Assistant
- Overland Park, KS
National Provider Identifier
1437868411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 10701 Nall Ave Ste 100
Overland Park, KS 66211-1244 - Phone
- (913) 338-5585
- Fax
- (913) 338-3228
- NPI assigned
- Nov 18, 2022
- Last updated
- Feb 9, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 14230205-1206 | UT | |
| Physician Assistant | 363A00000X | NU | Primary | |
| Medical Physician Assistant | 363AM0700X | 14230205-1206 | UT |
Addresses
Primary practice location
10701 Nall Ave Ste 100
Overland Park, KS 66211-1244
Mailing address
10701 Nall Ave Ste 100
Overland Park, KS 66211-1244
Phone (913) 338-5585
Other practice location 1
82 S 1100 E Ste 103
Salt Lake City, UT 84102-1889
Phone (801) 505-5370
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1502919 | Other | KS | KS LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, KS, UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
82 S 1100
Suite 103
Salt Lake City, UT 84102-1889
Phone (801) 505-5370
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14230205-1206 | UT | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catholic Health Initiatives Colorado | Current | Accepting new patients | |
| Catholic Health Initiatives Colorado | Current | Accepting new patients | |
| Catholic Health Initiatives Colorado | Current | Accepting new patients | |
| Catholic Health Initiatives Colorado | Past | Accepting new patients |
Locations
82 S 1100 E
Ste 103
Salt Lake Cty, UT 84102
Phone (801) 505-5370
Organizations & group practices 5
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.
-
dba Behavioral Health West Valley
- Prescribing (Medical) Psychologist
- West Valley City, UT
- NPI 1942903562
-
dba CRSL Cardio SLC
- Cardiovascular Disease Physician
- Salt Lake City, UT
- NPI 1265135420
-
dba CommonSpirit Orthopedics Longmont
- Orthopaedic Surgery Physician
- Longmont, CO
- NPI 1891675294
-
dba NSSH Neurosurg Sah
- Neurological Surgery Physician
- Lakewood, CO
- NPI 1205846664
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Holy Cross Hospital - Salt Lake
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1043915523
-
dba Holy Cross Hospital - Jordan Valley
- General Acute Care Hospital
- West Jordan, UT
- NPI 1801591391
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770595200000",
"number": "1437868411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10701 NALL AVE STE 100",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662111244",
"telephone_number": "913-338-5585",
"fax_number": "913-338-3228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10701 NALL AVE STE 100",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662111244",
"telephone_number": "913-338-5585",
"fax_number": "913-338-3228"
}
],
"practiceLocations": [
{
"address_1": "82 S 1100 E Ste 103",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "841021889",
"country_code": "US",
"telephone_number": "801-505-5370",
"fax_number": "801-984-6655",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ELLIS",
"first_name": "KAITLYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-18",
"last_updated": "2026-02-09",
"certification_date": "2026-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "14230205-1206",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "UT",
"license": "14230205-1206",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KS LICENSE",
"identifier": "1502919",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Overland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; 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.