Individual provider Active NPI

Kendall Moeller, DNP, FNP-C, BSN, RN

  • Family Nurse Practitioner
  • Farmington, UT
National Provider Identifier
1871212928
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
219778 Issued in AZ
Practice address
286 S 200 W Ste 210
Farmington, UT 84025-2425
Phone
(801) 852-8300
Fax
(801) 478-6250
NPI assigned
Aug 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95260559 CA
Registered Nurse 163W00000X 219778 AZ
Nurse Practitioner 363L00000X 14264108-44-5 UT
Family Nurse Practitioner 363LF0000X 219778 AZ Primary
Registered Nurse 163W00000X RN60856061 WA
Registered Nurse 163W00000X RN2353354 MA

Addresses

Primary practice location

286 S 200 W Ste 210
Farmington, UT 84025-2425

Mailing address

286 S 200 W Ste 210
Farmington, UT 84025-2425
Phone (801) 852-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20250312001743 AZ Practitioner - Nurse Practitioner 3476074972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialists in Dermatology P L L CGroup PAC ID 7012809726, 12 clinicians

Practice addresses (Care Compare)

2732 N Alvernon Way
Tucson, AZ 85712-1804
Phone (520) 319-1100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
95260559CAMDRegistered Nurse
RN2353354MAMDRegistered Nurse
RN60856061WAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Monogram Health Professional Services PC Nurse Practitioner PastSince Mar 22, 2023 Accepting new patients
Monogram Health Professional Services PC Nurse Practitioner Past Accepting new patients

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": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1871212928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 S 200 W STE 210",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252425",
            "telephone_number": "801-852-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 S 200 W STE 210",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252425",
            "telephone_number": "801-852-8300",
            "fax_number": "801-478-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOELLER",
        "first_name": "KENDALL",
        "credential": "DNP, FNP-C, BSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95260559",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "219778",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "14264108-44-5",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "219778",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60856061",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2353354",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, UT

Sources for this page

Verify at the official NPI Registry.