Individual provider Active NPI

Katie Ann Toledo

  • Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1881884252
Registry record updated Apr 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
TAPN700363 Issued in NV
Practice address
1053 E 2100 S
Suite 4
Salt Lake City, UT 84106-2060
Phone
(801) 359-3995
Fax
(801) 359-8489
NPI assigned
Jul 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X TAPN700363 NV Primary

Addresses

Primary practice location

1053 E 2100 S
Suite 4
Salt Lake City, UT 84106-2060

Mailing address

1053 E 2100 S
Salt Lake City, UT 84106-2060
Phone (801) 359-3995

Other names 1

  • Katie Ann Hurley Former name

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
I20110609000159 UT Practitioner - Nurse Practitioner 7719072883 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TAPN700363NVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Sep 18, 2015 Accepting new patients
Dudley Chiropractic & Wellness Center LC CurrentSince May 20, 2013 Accepting new patients
University of Utah Adult Services CurrentSince Sep 18, 2015 Accepting new patients
University of Utah Adult Services Current Accepting new patients
Lifetree Medical Inc Past Accepting new patients

Locations

2505 E 3300 S
Ste 201
Salt Lake Cty, UT 84109
Phone (801) 359-3995

1053 E 2100 S
Slc, UT 84106
Phone (801) 359-3955

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 5

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": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493337600000",
    "number": "1881884252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1053 E 2100 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062060",
            "telephone_number": "801-359-3995",
            "fax_number": "801-359-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1053 E 2100 S",
            "address_2": "SUITE 4",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062060",
            "telephone_number": "801-359-3995",
            "fax_number": "801-359-8489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLEDO",
        "first_name": "KATIE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2017-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "TAPN700363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "HURLEY",
            "middle_name": "ANN",
            "credential": "APN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.