Kimberly Lynn Tagg, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5644836-4405 Issued in UT

Practice address

550 N Main St Ste 117
Logan, UT 84321-3984

Phone

(435) 265-1675

Fax

(800) 549-9403

NPI assigned

Apr 18, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Logan Regional Hospital Hospital, Logan, UT, CCN 460015

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21521/brand/1/csg/1/fhir/r4

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.

• Northern Valley Family Medicine

  • Family Nurse Practitioner
  • Logan, UT
  • NPI 1285430207
  Medicare reassignment NPD Authorized official
• Be Well Medical, PLLC

  • Primary Care Clinic/Center
  • Hyde Park, UT
  • NPI 1669092169
  Medicare reassignment NPD
• Misustin Chiropractic PC

  • Sports Physician Chiropractor
  • Logan, UT
  • NPI 1801070628
  NPD

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

• Ihc Health Services Inc

  • General Acute Care Hospital
  • Logan, UT
  • NPI 1831108497
  Care Compare affiliation

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

{
    "created_epoch": "1618704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1801477286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W 3400 S",
            "city": "NIBLEY",
            "state": "UT",
            "postal_code": "843216461",
            "telephone_number": "435-265-1675",
            "fax_number": "800-549-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 N MAIN ST STE 117",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843213984",
            "telephone_number": "435-265-1675",
            "fax_number": "800-549-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGG",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-18",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "5644836-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Synergy Soft Tissue
• Systems-Based Therapy, PLLC
• Agnieszka M Szpunar, MD
• Val Szpunar, P.T.
• Paige Alene Tackett
• Alexa Talatau
• Skyler Talbot, FNP
• Noah Ross Tangren, BABC
• Tanner Hunsaker DDS, PLLC
• Jessica Jo Tarbet, BCBA

• Family Nurse Practitioner in Logan, UT
• Providers in Logan, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.
• 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.