Brian Bennett Koldyke, MSN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5850890-4405 Issued in UT

Practice address

577 S River Rd
St George, UT 84790-2097

Phone

(435) 688-6262

Fax

(435) 688-6263

NPI assigned

Sep 26, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St. George Regional Hospital Hospital, St George, UT, CCN 460021

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

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
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment Care Compare group NPD
• Ihc Health Services Inc

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • St George, UT
  • NPI 1417238601
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD

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

• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • St George, UT
  • NPI 1366452880
  Care Compare affiliation

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

{
    "created_epoch": "1380153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1609203363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 S RIVER RD",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847902097",
            "telephone_number": "435-688-6262",
            "fax_number": "435-688-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 S RIVER RD",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847902097",
            "telephone_number": "435-688-6262",
            "fax_number": "435-688-6263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLDYKE",
        "first_name": "BRIAN",
        "middle_name": "BENNETT",
        "name_prefix": "Mr.",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-26",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "5850890-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Kofford, MFT
• Martin Koford, ACMHC
• Austin Robert Kogan
• Lisa Kogan, FNP
• Shawn Kolar, PHARMD.
• Kolob Therapeutic Services
• Kenza Komara
• Jayce Komiya
• Yocoli Konan
• Rebekah Korn

• Family Nurse Practitioner in St George, UT
• Providers in St George, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.