Kalista Makenzie McMullin

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

12975313-4104 Issued in UT

Practice address

168 N 100 E Ste 225
St George, UT 84770-2893

Phone

(435) 669-4109

NPI assigned

Aug 30, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1629798707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 RED MOUNTAIN DR",
            "city": "SANTA CLARA",
            "state": "UT",
            "postal_code": "847655201",
            "telephone_number": "435-669-4109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 N 100 E STE 225",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847702893",
            "telephone_number": "435-669-4109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLIN",
        "first_name": "KALISTA",
        "middle_name": "MAKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "UT",
            "license": "12975313-4104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kalista@pricklypearkids.com",
            "affiliation": "N",
            "address_1": "168 N 100 E Ste 225",
            "city": "St George",
            "state": "UT",
            "country_code": "US",
            "postal_code": "847702893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kelsea McKinley
• Tasha Marie McKissack
• Kristina Tiffany McMahon, APRN, FNP-C
• Samantha McMahon
• McCall Jo McMorris, PMHNP-BC
• Karl T McMullin, NP
• Megan Anne McNally, LMFT
• Maryann McNamara
• Ethan McNamee
• Joe McNatt

• Speech-Language Pathologist in St George, UT
• Providers in St George, UT by specialty
• Speech-Language Pathologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.