Kraig Lynn Packer, NPC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

261539-4405 Issued in UT

Practice address

3339 Cherokee LN
Provo, UT 84604-4866

Phone

(801) 803-0877

NPI assigned

Aug 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Merit-based Incentive Payment System (MIPS)

Final score

61.24 of 100Reported as group

Quality

58.16

Promoting interoperability

0

Improvement activities

40

Cost

62.65

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880

  Family Medicine

  Medicare reassignment NPD
• Senior Health LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Woods Cross, UT
  • NPI 1134721228
  Medicare reassignment NPD
• Western Medical Consultants

  • Internal Medicine Physician
  • Draper, UT
  • NPI 1790175073
  Medicare reassignment
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Logan, UT
  • NPI 1760616528
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Senior Health LLC

  • Emergency Response System Companies
  • Woods Cross, UT
  • NPI 1497221618
  NPD

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1518959535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3339 CHEROKEE LN",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846044866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3339 CHEROKEE LN",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846044866",
            "telephone_number": "801-803-0877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1175 E 50 S Ste 251",
            "address_purpose": "LOCATION",
            "city": "American Fork",
            "state": "UT",
            "postal_code": "840032850",
            "country_code": "US",
            "telephone_number": "801-354-8225",
            "fax_number": "801-429-8191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "972 N 600 E",
            "address_purpose": "LOCATION",
            "city": "Spanish Fork",
            "state": "UT",
            "postal_code": "846601306",
            "country_code": "US",
            "telephone_number": "801-373-4366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACKER",
        "first_name": "KRAIG",
        "middle_name": "LYNN",
        "name_prefix": "Mr.",
        "credential": "NPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "261539-4405",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "115014",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "UT",
            "license": "261539-4405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50634879",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vickie Pace
• Pacific Medical
• Jade Pack
• Kellie Pack
• Calvin Reeves Packer
• Stephanie Packer
• Christine Padilla, ATC, LAT
• Saskia Bernarela Paepke-Chile
• Emily Rose Page
• Sam Ray Page, M.D.

• Adult Health Nurse Practitioner in Provo, UT
• Providers in Provo, UT by specialty
• Adult Health Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.

Verify at the official NPI Registry.