Individual provider Active NPI

Kathleen Ann Stillion-Allen, A.P.R.N.

  • Family Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1770615296
Registry record updated Dec 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2026014405 Issued in UT
Practice address
1856 E 4650 S
Salt Lake City, UT 84117-5102
Phone
(801) 819-4919
Fax
(801) 274-6129
NPI assigned
Mar 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2012

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 2026014405 UT Primary

Addresses

Primary practice location

1856 E 4650 S
Salt Lake City, UT 84117-5102

Mailing address

1856 E 4650 S
Salt Lake City, UT 84117-5102
Phone (801) 819-4919

Other identifiers 4

IdentifierTypeStateIssuer
XXXXXXXXXX0601OtherBLUE CROSS/BLUE SHIELD
XXXXXXXXX002MedicaidUT
236004OtherUTALTIUS
7648OtherUTHEALTHY U

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Demers Mental Health Past Accepting new patients
Nurse Practitioner Healthcare Associates PastSince Dec 21, 2004 Accepting new patients

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": "1173484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356912000000",
    "number": "1770615296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1856 E 4650 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841175102",
            "telephone_number": "801-819-4919",
            "fax_number": "801-274-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1856 E 4650 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841175102",
            "telephone_number": "801-819-4919",
            "fax_number": "801-274-6129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLION-ALLEN",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "A.P.R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-10",
        "last_updated": "2012-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "2026014405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "XXXXXXXXXX0601",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XXXXXXXXX002",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS",
            "identifier": "236004",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY U",
            "identifier": "7648",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.