Individual provider Active NPI

Kristen Bolke, N.P.

  • Family Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1467617084
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5922494-4405 Issued in UT
Practice address
50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone
(801) 585-6393
NPI assigned
Jul 23, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5922494-4405 UT Primary

Addresses

Primary practice location

50 N Medical Dr
Salt Lake City, UT 84132-0001

Mailing address

2107 E 3300 S Apt D
Salt Lake City, UT 84109-4401
Phone (801) 178-7371

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
I20090127000436 UT Practitioner - Nurse Practitioner 2163586793 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

5121 S Cottonwood St
Murray, UT 84107-5701
Phone (801) 314-2400

5848 S Fashion Blvd
The Orthopedic Specialty Hosp Physicans Gro
Murray, UT 84107-6121
Phone (801) 314-4100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Feb 4, 2021 Accepting new patients
Ihc Health Services Inc CurrentSince May 31, 2021 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Nurse Practitioner Current Accepting new patients
Ihc Health Services Inc CurrentSince Feb 4, 2021 Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

8th Ave And C St
Salt Lake City, UT 84143
Phone (801) 350-4110

5848 S Fashion Blvd
Salt Lake Cty, UT 84107
Phone (801) 314-4040

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

Organizations & group practices 6

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216771200000",
    "number": "1467617084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2107 E 3300 S APT D",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841094401",
            "telephone_number": "801-178-7371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-585-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLKE",
        "first_name": "KRISTEN",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-23",
        "last_updated": "2008-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "5922494-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.