Individual provider Active NPI

Chidiebere Iheanacho

  • Acute Care Nurse Practitioner
  • North Salt Lake, UT
National Provider Identifier
1598549370
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
8326025-4405 Issued in UT
Practice address
175 Odell LN
North Salt Lake, UT 84054-4100
Phone
(801) 867-0632
NPI assigned
Aug 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 8326025-4405 UT Primary

Addresses

Primary practice location

175 Odell LN
North Salt Lake, UT 84054-4100

Mailing address

175 Odell LN
North Salt Lake, UT 84054-4100
Phone (801) 867-0632

Other practice location 1

3336 S Pioneer Pkwy Ste 203
West Valley City, UT 84120-6077
Phone (801) 290-7153

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ciheanacho88724@direct.med.utah.edu Direct University of Utah

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
I20240305001640 UT Practitioner - Nurse Practitioner 0345685970 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Utah School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

3336 S 4155
Suite 203
West Valley City, UT 84120
Phone (801) 290-7153

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 585-6387

Hospital & facility affiliations

  • University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009
  • Holy Cross Hospital-Jordan Valley Hospital, West Jordan, UT, CCN 460051
  • Northeastern Nevada Regional Hospital Hospital, Elko, NV, CCN 290008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8326025-4405UTMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince Feb 1, 2026 Accepting new patients
University of Utah Adult Services CurrentSince Feb 1, 2024 Accepting new patients
University of Utah Adult Services Current Accepting new patients
Signify Health, LLC CurrentSince Mar 1, 2025 Accepting new patients
University of Utah Adult Services CurrentSince Feb 1, 2024 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Feb 1, 2026 Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients
Heart and Lung Institute of Utah Inc PastSince Feb 1, 2026 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

82 S 1100 E
Ste 103
Salt Lake Cty, UT 84102
Phone (801) 505-5370

9980 S 300 W
Ste 200
Sandy, UT 84070
Phone (801) 285-7403

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

Interoperability endpoints

  • Direct secure messaging: ciheanacho88724@direct.med.utah.edu

Organizations & group practices 9

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 5

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": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1598549370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 ODELL LN",
            "city": "NORTH SALT LAKE",
            "state": "UT",
            "postal_code": "840544100",
            "telephone_number": "801-867-0632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 ODELL LN",
            "city": "NORTH SALT LAKE",
            "state": "UT",
            "postal_code": "840544100",
            "telephone_number": "801-867-0632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3336 S Pioneer Pkwy Ste 203",
            "address_purpose": "LOCATION",
            "city": "West Valley City",
            "state": "UT",
            "postal_code": "841206077",
            "country_code": "US",
            "telephone_number": "801-290-7153",
            "fax_number": "801-748-0113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IHEANACHO",
        "first_name": "CHIDIEBERE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-22",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "UT",
            "license": "8326025-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ciheanacho88724@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in North Salt Lake, UT

Sources for this page

Verify at the official NPI Registry.