Individual provider Active NPI

Katherine Hadley Wolpert, MD

  • Pediatrics Physician
  • Salt Lake City, UT
National Provider Identifier
1598007932
Registry record updated Apr 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
61039332 Issued in WA
Practice address
100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone
(765) 491-3208
NPI assigned
Mar 25, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 61039332 WA Primary

Addresses

Primary practice location

100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103

Mailing address

100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone (765) 491-3208

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160609002259 UT Practitioner - Pediatric Medicine 1658593934 Reassigns benefits to 2 organizations
I20200713002225 WA Practitioner - Pediatric Medicine 1658593934 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
61039332WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Pediatric Acuity Care Pediatrics Current Accepting new patients
University of Utah Pediatric Acuity Care CurrentSince Sep 1, 2016 Accepting new patients
University of Utah Pediatric Services CurrentSince Oct 1, 2016 Accepting new patients
University of Utah Pediatric Acuity Care CurrentSince Sep 1, 2016 Accepting new patients
University of Utah Pediatric Services Pediatrics Current Accepting new patients
The Association of Chrmc and University Physicians Pediatrics CurrentSince Jul 1, 2020 Accepting new patients
Association of CHMC and University Physicians Pediatrics CurrentSince Jul 1, 2020 Accepting new patients
University of Utah Pediatric Services CurrentSince Oct 1, 2016 Accepting new patients

Locations

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

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

127 S 500 E
Ste 600
Slc, UT 84102

900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

Interoperability endpoints

  • Direct secure messaging: kwolpert95940@direct.seattlechildrens.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586649600000",
    "number": "1598007932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "765-491-3208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "765-491-3208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLPERT",
        "first_name": "KATHERINE",
        "middle_name": "HADLEY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-25",
        "last_updated": "2020-04-12",
        "certification_date": "2020-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "61039332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.