Individual provider Active NPI

Candice Kai Roberts, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Ogden, UT
National Provider Identifier
1801539929
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
7001829-4405 Issued in UT
Practice address
3903 Harrison Blvd Ste 300
Ogden, UT 84403-2362
Phone
(801) 387-5600
NPI assigned
Apr 16, 2022
Last updated
Mar 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 7001829-4405 UT Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 7001829-3101 UT

Addresses

Primary practice location

3903 Harrison Blvd Ste 300
Ogden, UT 84403-2362

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

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
I20230215000982 UT Practitioner - Nurse Practitioner 3274905575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

3903 Harrison Blvd
Suite 300
Ogden, UT 84403-2362
Phone (801) 387-5600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7001829-3101UTMDPsychiatric/Mental Health Registered Nurse
7001829-4405UTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. Psychiatry CurrentSince Oct 28, 2022 Accepting new patients
Ihc Health Services Inc CurrentSince Oct 28, 2022 Accepting new patients
Ihc Health Services Inc Current Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

3903 Medical Dr
Ste 300
Ogden, UT 84403
Phone (801) 387-4930

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1650067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1801539929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 HARRISON BLVD STE 300",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844032362",
            "telephone_number": "801-387-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CANDICE",
        "middle_name": "KAI",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-16",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "7001829-4405",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "UT",
            "license": "7001829-3101",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.