Sandra B Waite, CFNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

210069-4405 Issued in UT

Practice address

520 Medical Dr
210
Bountiful, UT 84010-4968

Phone

(801) 298-9155

NPI assigned

Jan 17, 2007

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

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.

• Wade Family Medicine, Inc.

  • Family Medicine Physician
  • Bountiful, UT
  • NPI 1558597831
  NPD

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699827014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 REBECCA CIR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841175863",
            "telephone_number": "801-272-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MEDICAL DR",
            "address_2": "210",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104968",
            "telephone_number": "801-298-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAITE",
        "first_name": "SANDRA",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "210069-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Starr Wagner Pollard, DNP, APRN, FNP-C
• Daniel Wayner Wagner
• Jessica Keely Wahl, OT
• Savanah A. Wahlen
• Waikoloa
• John Oliver Wald, MCD
• Jake Walden, DC
• Walgreen Co
• Walgreen Co
• Kimberly Gail Walker, ACSM- EP, CET

• Family Nurse Practitioner in Bountiful, UT
• Providers in Bountiful, 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 8, 2007; 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.