Kaitlin Ellison, APRN

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

10385255-4405 Issued in UT

Practice address

1525 E 6000 S
South Ogden, UT 84405-7144

Phone

(801) 337-5800

NPI assigned

Jun 19, 2023

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Circle of Life IncGroup PAC ID 5193703544, 10 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Circle of Life Inc

  • Obstetrics & Gynecology Physician
  • South Ogden, UT
  • NPI 1548284078
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1730864786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 E 6000 S",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844057144",
            "telephone_number": "801-337-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E 6000 S",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844057144",
            "telephone_number": "801-337-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "KAITLIN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "UT",
            "license": "10385255-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna Earle
• Earline Marchello
• Edge Medical Services
• Jennifer Swanhild Edwards
• Megan Eldridge
• Joshua Elzey, DPT
• Eos Serenity Lodge
• Taylor Paul Ericksen, D.M.D.
• Madeline Evans
• Fanelli Orthodontics PLLC

• Women's Health Nurse Practitioner in South Ogden, UT
• Providers in South Ogden, UT by specialty
• Women's Health Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; 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.