Individual provider Active NPI

Kori Dee Richards, FNP-C

  • Family Nurse Practitioner
  • Kaysville, UT
National Provider Identifier
1881400711
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4782619-4405 Issued in UT
Practice address
508 S 25 E
Kaysville, UT 84037-3518
Phone
(801) 643-3496
NPI assigned
Dec 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4782619-8900 UT
Family Nurse Practitioner 363LF0000X 4782619-4405 UT Primary

Addresses

Primary practice location

508 S 25 E
Kaysville, UT 84037-3518

Mailing address

508 S 25 E
Kaysville, UT 84037-3518
Phone (801) 643-3496

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
I20250909004583 UT Practitioner - Nurse Practitioner 9537662382 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
Telehealth
Offers telehealth services
Group practices
Utah Pain and Rehab LLCGroup PAC ID 4284140088, 5 clinicians

Practice addresses (Care Compare)

1276 Wall Ave
Suite 1
Ogden, UT 84404-5673
Phone (801) 337-4000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4782619-8900UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Pain & Rehab LLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

1276 Wall Ave
Ste 1
Ogden, UT 84404
Phone (801) 337-4000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1881400711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 S 25 E",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840373518",
            "telephone_number": "801-643-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 S 25 E",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840373518",
            "telephone_number": "801-643-3496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "KORI",
        "middle_name": "DEE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "4782619-8900",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "4782619-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaysville, UT

Sources for this page

Verify at the official NPI Registry.