Individual provider Active NPI

Kristen Michelle Dawson, DNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Sandy, UT
National Provider Identifier
1588294284
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11581566-4405 Issued in UT
Practice address
9035 S 1300 E Ste 120
Sandy, UT 84094-3192
Phone
(801) 455-0045
NPI assigned
Jan 22, 2020
Last updated
May 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11581566-4405 UT Primary
Registered Nurse 163W00000X 11581566-3102 UT

Addresses

Primary practice location

9035 S 1300 E Ste 120
Sandy, UT 84094-3192

Mailing address

2223 S Highland Dr
Ste E6 # 244
Salt Lake City, UT 84106
Phone (385) 420-0418

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11581566-3102UTMDRegistered Nurse
11581566-4405UTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amber Creek Counseling and Psychiatry Inc PastSince May 14, 2023 Accepting new patients

Organizations & group practices 1

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": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1588294284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2223 S HIGHLAND DR",
            "address_2": "STE E6 # 244",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84106",
            "telephone_number": "385-420-0418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9035 S 1300 E STE 120",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840943192",
            "telephone_number": "801-455-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "KRISTEN",
        "middle_name": "MICHELLE",
        "credential": "DNP, PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-22",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "11581566-4405",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "11581566-3102",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.