Kearsta Kayleen Washburn, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

6224506-4405 Issued in UT

Practice address

835 E 4800 S Ste 230
Murray, UT 84107-5535

Phone

(801) 716-7008

NPI assigned

Jul 4, 2018

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Empowering Vitality LLC

  • Family Nurse Practitioner
  • Tooele, UT
  • NPI 1912851049
  NPD Authorized official

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

{
    "created_epoch": "1530662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530662400000",
    "number": "1669968491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "378 S 400 W",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840742620",
            "telephone_number": "801-673-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 E 4800 S STE 230",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075535",
            "telephone_number": "801-716-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHBURN",
        "first_name": "KEARSTA",
        "middle_name": "KAYLEEN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-04",
        "last_updated": "2018-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "6224506-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wasatch Integrated Wellness, LLC
• Wasatch Neurological Clinic
• Wasatch Psychotherapy and Consulting
• Wasatch Wellness Center LLC
• Andrea Washburn Landscaping Washburn, SUDCI, BHTI
• Kristin Croughwell Washburn, MD
• Savannah Rraine Washburn
• Karen M Waskowicz, NP
• Monet Watanabe
• Amanda Waterman

• Family Nurse Practitioner in Murray, UT
• Providers in Murray, 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 Jul 4, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.