Individual provider Active NPI

Kristy Martin, FNP-BC

  • Acute Care Nurse Practitioner
  • West Valley City, UT
National Provider Identifier
1790152973
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
9484112-4405 Issued in UT
Practice address
2750 S 5600 W
West Valley City, UT 84120-1249
Phone
(801) 417-5732
NPI assigned
Aug 24, 2015
Last updated
Jul 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9484112-4405 UT
Acute Care Nurse Practitioner 363LA2100X 9484112-4405 UT Primary

Addresses

Primary practice location

2750 S 5600 W
West Valley City, UT 84120-1249

Mailing address

1758 S Laurelhurst Dr
Salt Lake City, UT 84108-3310
Phone (978) 457-5992

Other practice location 1

3665 S 8400 W
Ste 110
Magna, UT 84044-4907
Phone (801) 250-9638

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
I20210414001274 UT Order and Referring Only - Nurse Practitioner 2365742624

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1790152973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1758 S LAURELHURST DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841083310",
            "telephone_number": "978-457-5992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 S 5600 W",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841201249",
            "telephone_number": "801-417-5732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3665 S 8400 W",
            "address_2": "Ste 110",
            "address_purpose": "LOCATION",
            "city": "Magna",
            "state": "UT",
            "postal_code": "840444907",
            "country_code": "US",
            "telephone_number": "801-250-9638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KRISTY",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "9484112-4405",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "UT",
            "license": "9484112-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley City, UT

Sources for this page

Verify at the official NPI Registry.