Kendra Staheli, DNP, PMHNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

8632096-4405 Issued in UT

Practice address

395 W Bulldog Blvd Ste 601
Provo, UT 84604-3331

Phone

(801) 357-7525

Fax

(801) 357-7746

NPI assigned

Jul 11, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment Care Compare group NPD
• Ihc Health Services Inc

  • Hospitalist Physician
  • St George, UT
  • NPI 1861522799
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1861044604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 W COUGAR BLVD STE 601",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043331",
            "telephone_number": "801-357-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W BULLDOG BLVD STE 601",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043331",
            "telephone_number": "801-357-7525",
            "fax_number": "801-357-7746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHELI",
        "first_name": "KENDRA",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "8632096-4405",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "8632096-8900",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "8632096-4405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matthew.staheli@direct.imail.org",
            "affiliation": "N",
            "address_1": "395 W Bulldog Blvd Ste 601",
            "city": "Provo",
            "state": "UT",
            "country_code": "US",
            "postal_code": "846043331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Squire Counseling
• Jasmeen Sran
• SRS-Provo, LLC
• Shawna Marie St. Clair
• John K Staheli, MD
• Monica Staheli
• Zachary Kenneth Staley
• Emily Ann Stallings, OTR
• Jasmine Alexis Stamler, FNP-C
• Standard Optical Co

• Nurse Practitioner in Provo, UT
• Providers in Provo, UT by specialty
• Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.