Active NPI
Klinton Lane Brearton, DNP
- Nurse Practitioner
- Orem, UT
National Provider Identifier
1922574532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 8459664-4405
- Practice address
- 1443 W 800 N Ste 302
Orem, UT 84057-2883 - Phone
- (801) 655-0015
- Fax
- (801) 655-0048
- NPI assigned
- Oct 22, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 8459664-4405 | UT | Primary |
Addresses
Primary practice location
1443 W 800 N Ste 302
Orem, UT 84057-2883
Mailing address
1443 W 800 N Ste 302
Orem, UT 84057-2883
Phone (801) 655-0015
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Male Fertility and Peyronie'S Clinic | Nurse Practitioner | Current | Accepting new patients |
Locations
1443 W 800 N
Ste 302
Orem, UT 84057
Phone (801) 235-0953
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": "1540166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620777600000",
"number": "1922574532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1443 W 800 N STE 302",
"city": "OREM",
"state": "UT",
"postal_code": "840572883",
"telephone_number": "801-655-0015",
"fax_number": "801-655-0048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1443 W 800 N STE 302",
"city": "OREM",
"state": "UT",
"postal_code": "840572883",
"telephone_number": "801-655-0015",
"fax_number": "801-655-0048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREARTON",
"first_name": "KLINTON",
"middle_name": "LANE",
"credential": "DNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-10-22",
"last_updated": "2021-05-12",
"certification_date": "2021-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "UT",
"license": "8459664-4405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orem, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.