Individual provider Active NPI

Kandice Rose Nielson, M.D.

  • Obstetrics & Gynecology Physician
  • Ogden, UT
National Provider Identifier
1720252513
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
829812-1205 Issued in UT
Practice address
4403 Harrison Blvd Ste 4815
Ogden, UT 84403-3333
Phone
(801) 387-8350
Fax
(801) 387-8355
NPI assigned
Apr 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 829812-1205 UT Primary

Addresses

Primary practice location

4403 Harrison Blvd Ste 4815
Ogden, UT 84403-3333

Mailing address

PO Box 27128
Ste 340
Salt Lake City, UT 84127-0128
Phone (801) 706-4888

Other practice location 1

620 Medical Dr.
Ste 340
Bountiful, UT 84010
Phone (801) 299-2229

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kandice.nielson@direct.imail.org

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120918000124 UT Practitioner - Obstetrics/Gynecology 0648428664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Geisel School of Medicine at Dartmouth, 2008
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)

4403 Harrison Blvd
Suite 4875
Ogden, UT 84403-3335
Phone (801) 387-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
829812-1205UTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Mar 1, 2016 Accepting new patients
Ihc Health Services Inc CurrentSince Mar 1, 2016 Accepting new patients
Lakeview Hospital Physician Services LLC Obstetrics & Gynecology PastSince Oct 17, 2017 Accepting new patients
Joshua Oaks MD PLLC Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

4403 Harrison Blvd
Ste 4815
Ogden, UT 84403
Phone (801) 387-8350

4403 Harrison Blvd
Ste 4875
Ogden, UT 84403
Phone (801) 387-4500

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1720252513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "address_2": "STE 340",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-706-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD STE 4815",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033333",
            "telephone_number": "801-387-8350",
            "fax_number": "801-387-8355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 Medical Dr.",
            "address_2": "Ste 340",
            "address_purpose": "LOCATION",
            "city": "Bountiful",
            "state": "UT",
            "postal_code": "84010",
            "country_code": "US",
            "telephone_number": "801-299-2229",
            "fax_number": "801-299-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIELSON",
        "first_name": "KANDICE",
        "middle_name": "ROSE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-14",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": "829812-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kandice.nielson@direct.imail.org",
            "affiliation": "N",
            "address_1": "620 Medical Dr.",
            "address_2": "Ste 340",
            "city": "Bountiful",
            "state": "UT",
            "country_code": "US",
            "postal_code": "84010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.