Individual provider Active NPI

Kristen Michele Henrie, MSN, NP-C

  • Family Nurse Practitioner
  • Kaysville, UT
National Provider Identifier
1730462102
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4916405-4405 Issued in UT
Practice address
1833 W 200 N
Kaysville, UT 84037-9722
Phone
(801) 390-8233
NPI assigned
Sep 22, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4916405-4405 UT Primary

Addresses

Primary practice location

1833 W 200 N
Kaysville, UT 84037-9722

Mailing address

1833 W 200 N
Kaysville, UT 84037-9722
Phone (801) 390-8233

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230825002351 UT Practitioner - Nurse Practitioner 0446405708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interventional Spine and Pain ManagementGroup PAC ID 6204065162, 13 clinicians

Practice addresses (Care Compare)

1276 Wall Ave
Suite 2
Ogden, UT 84404-5673
Phone (801) 262-7246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
21797CAMDFamily Medicine Physician
4916405-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Spine & Pain Management CurrentSince Jul 2, 2023 Accepting new patients
Interventional Spine & Pain Management CurrentSince Jul 2, 2023 Accepting new patients

Locations

1276 Wall Ave
Ste 2
Ogden, UT 84404
Phone (801) 781-0651

560 W 465 N
Ste 604
Providence, UT 84332
Phone (435) 753-1600

5801 S Fashion Blvd
Ste 180
Salt Lake City, UT 84107
Phone (801) 706-2100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HDBECA

Organizations & group practices 2

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": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1730462102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1833 W 200 N",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840379722",
            "telephone_number": "801-390-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 W 200 N",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840379722",
            "telephone_number": "801-390-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRIE",
        "first_name": "KRISTEN",
        "middle_name": "MICHELE",
        "credential": "MSN, NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "4916405-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaysville, UT

Sources for this page

Verify at the official NPI Registry.