Kristen Lile, D.O.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

12227268-1204 Issued in UT

Practice address

1055 N 500 W Ste 222
Provo, UT 84604-3305

Phone

(801) 812-5033

NPI assigned

Apr 18, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Kristen Roberson Former name

Electronic endpoints 2

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

Specialty

Nephrology

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• 462307 Logan Regional Hospital Dialysis Center Dialysis facility, Logan, UT, CCN 462307
• DaVita Bonneville Dialysis Center Dialysis facility, Ogden, UT, CCN 462519
• Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004
• Intermountain Health Logan Regional Hospital Hospital, Logan, UT, CCN 460015
• Intermountain Health Layton Hospital Hospital, Layton, UT, CCN 460061
• Bear River Valley Hospital Hospital, Tremonton, UT, CCN 460039

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment Care Compare group NPD
• Ihc Health Services Inc

  dba North Ogden Clinic - InstaCare

  • Emergency Medicine Physician
  • North Ogden, UT
  • NPI 1033240460
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Ihc Health Services Inc

  dba Orem Community Hospital Physicians

  • Multi-Specialty Clinic/Center
  • Orem, UT
  • NPI 1588601124
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Utlo Partners, LLC

  dba U.S. Renal Care Logan Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Logan, UT
  • NPI 1184388191

  Dialysis facility

  Care Compare affiliation Name & address match
• Ihc Health Services Inc

  dba Intermountain Health McKay-Dee Hospital

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1194749580
  Care Compare affiliation
• Ihc Health Services Inc

  dba Intermountain Health Bear River Valley Hospital

  • General Acute Care Hospital
  • Tremonton, UT
  • NPI 1679582944
  Care Compare affiliation
• Ihc Health Services Inc

  dba Intermountain Health Logan Regional Hospital

  • General Acute Care Hospital
  • Logan, UT
  • NPI 1831108497
  Care Compare affiliation
• Ihc Health Services, Inc.

  dba Intermountain Health Layton Hospital

  • General Acute Care Hospital
  • Layton, UT
  • NPI 1417460205
  Care Compare affiliation

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1780038638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N 500 W STE 222",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-812-5033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12700 E 19th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452560",
            "country_code": "US",
            "telephone_number": "303-724-4851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 W SR 164",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "UT",
            "postal_code": "84653",
            "country_code": "US",
            "telephone_number": "801-377-4623",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3214 E Race Ave",
            "address_purpose": "LOCATION",
            "city": "Searcy",
            "state": "AR",
            "postal_code": "721434810",
            "country_code": "US",
            "telephone_number": "318-816-0103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LILE",
        "first_name": "KRISTEN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-18",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "12227268-1204",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "UT",
            "license": "12227268-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Central Utah Clinic, P.C.",
            "address_1": "1055 N 500 W Ste 222",
            "city": "Provo",
            "state": "UT",
            "country_code": "US",
            "postal_code": "846043305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Central Utah Clinic, P.C.",
            "address_1": "555 W SR 164",
            "city": "Salem",
            "state": "UT",
            "country_code": "US",
            "postal_code": "84653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "ROBERSON",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Nephrology Physician in Provo, UT
• Providers in Provo, UT by specialty
• Nephrology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.