Kellie Daugharty Lewis, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

322464-4405 Issued in UT

Practice address

39 Wanderwood Way
Sandy, UT 84092-4866

Phone

(801) 561-8398

Fax

(801) 302-0645

NPI assigned

Oct 27, 2006

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 identifiers 1

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.

• Senior Health LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Woods Cross, UT
  • NPI 1134721228
  Medicare reassignment NPD
• Western Medical Consultants

  • Internal Medicine Physician
  • Draper, UT
  • NPI 1790175073
  Medicare reassignment

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1750467155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1009",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840651009",
            "telephone_number": "801-561-8398",
            "fax_number": "801-302-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 WANDERWOOD WAY",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840924866",
            "telephone_number": "801-561-8398",
            "fax_number": "801-302-0645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHARTY LEWIS",
        "first_name": "KELLIE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "322464-4405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750467155",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexander James Dalley
• Clinton Dalton
• Heather Marie Dangerfield, DNP, PMHNP
• Daniel L. Masson, LLC
• Darrin F Hansen M.D. P.C.
• Jason Dausses
• David Anderson Dental LLC
• David R Boettger MD PC
• Bria N Davies
• Nina Davis, NP

• Nurse Practitioner in Sandy, UT
• Providers in Sandy, UT by specialty
• Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.