Active NPI
Kristy Martin, FNP-BC
- Acute Care Nurse Practitioner
- West Valley City, UT
National Provider Identifier
1790152973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 9484112-4405
- 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, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.