Kacie Lofgran, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

6998915-4405 Issued in UT

Practice address

1250 E 3900 S Ste 260
Salt Lake City, UT 84124-1371

Phone

(801) 265-2000

NPI assigned

Nov 23, 2016

Last updated

Dec 19, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kacie Egbert Former name

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Canyon Medical Group LLCGroup PAC ID 9032002373, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Logan Regional Hospital Hospital, Logan, UT, CCN 460015

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Canyon Medical Group LLC

  • Pediatrics Physician
  • Logan, UT
  • NPI 1952599409
  Medicare reassignment Care Compare group NPD
• Alberto Souza, PLLC

  dba Integrated Psych, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • St George, UT
  • NPI 1972141588
  NPD (past)

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

• Ihc Health Services Inc

  dba Intermountain Health Logan Regional Hospital

  • General Acute Care Hospital
  • Logan, UT
  • NPI 1831108497
  Care Compare affiliation

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

{
    "created_epoch": "1479859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1710420617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S",
            "address_2": "STE 260",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841241371",
            "telephone_number": "801-265-2000",
            "fax_number": "801-265-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S STE 260",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241371",
            "telephone_number": "801-265-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOFGRAN",
        "first_name": "KACIE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-23",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "6998915-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KACIE",
            "last_name": "EGBERT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lodge by Valeo, LLC
• Kanika Skye Lodge
• Brikenna Loertscher
• Kearsten Nicole Loertscher
• Natalie K Loewen, M.D.
• Darion Lofgren
• Mary Beth Lofgren, NP
• Iris Lofing
• Thomas Mack Loftis
• Lydia Loftus

• Family Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, 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 Dec 19, 2016; 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.