Kim Stevenson, APRN-NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

274276-4405 Issued in UT

Practice address

5620 S Waterbury Way # A200
Salt Lake City, UT 84121-1180

Phone

(801) 455-8822

Fax

(561) 589-6511

NPI assigned

Oct 8, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Kim Stevenson Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Exodus Healthcare Network PLLC

  • Family Medicine Physician
  • Magna, UT
  • NPI 1306952783
  Medicare reassignment
• Life Spring Pain Management, LLC

  • Health Service Clinic/Center
  • Kaysville, UT
  • NPI 1699115188
  Medicare reassignment
• Seventh Street Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Salt Lake City, UT
  • NPI 1235663345
  NPD
• Nextpain Medical PA

  • Pain Medicine Physician
  • Lawrenceville, GA
  • NPI 1295564334
  NPD
• C and B Family Practice LLC

  • Nurse Practitioner
  • Altonah, UT
  • NPI 1841825213
  NPD (past)

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1851542872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 S WATERBURY WAY # A200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841211180",
            "telephone_number": "801-455-8822",
            "fax_number": "561-589-6511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 S WATERBURY WAY # A200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841211180",
            "telephone_number": "801-455-8822",
            "fax_number": "561-589-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "KIM",
        "credential": "APRN-NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "274276-8900",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "274276-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "STEVENSON",
            "credential": "APRN-NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wade F Stevens, DDS
• Adam Thomas Stevenson
• Amanda E Stevenson, LMFT
• Camille Stevenson, MD
• Elizabeth Stevenson, CF-SLP
• Michael Thomas Stevenson, LCSW
• Nicole Stevenson
• Sara Stevenson, RDN
• Taelyr Stevenson, APRN
• Wayne Stevenson

• Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; 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.

Verify at the official NPI Registry.