Kaitlin Diane Connolly, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10827182-4405 Issued in UT

Practice address

1250 E 3900 S Ste 260
Salt Lake City, UT 84124-1371

Phone

(801) 265-2000

NPI assigned

Jun 14, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kaitlin.connolly.1@14940.direct.athenahealth.com

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.

• Utah Healthcare Institute Inc

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1376597344
  Medicare reassignment NPD
• Virtual Wellness Clinic

  • Family Medicine Physician
  • West Jordan, UT
  • NPI 1407793805
  NPD Authorized official

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1932839727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S STE 260",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241371",
            "telephone_number": "801-265-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S STE 260",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241371",
            "telephone_number": "801-265-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "KAITLIN",
        "middle_name": "DIANE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "10827182-4405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOPL",
            "identifier": "10827182-4405",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOPL",
            "identifier": "108271723102",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lacey Renee Conner
• Susan M. Conner, CPNP
• Thomas K. Conner, MD
• Dean B. Connolly, DDS
• Jeffrey D. Connolly, DDS
• Nona A Connolly, RN
• Kathryn E Connor, PT
• Rafe C Connors, MD
• Alexis Cononelos, SSW
• Alison Conover

• Family Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.