KATHLEEN ANN MACK (ARNP) – Family Nurse Practitioner, NPI 1326211624
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for KATHLEEN ANN MACK (ARNP)
1006 VANDERDASSON RD
EMMETT, ID 836178880
Phone: (208) 944-1537
Fax: (208) 944-6067
Type: Location
612 COUNTRY CLB
TOOELE, UT 840749604
Phone: (509) 731-5662
Type: Mailing
4460 S HIGHLAND DR STE 210
SALT LAKE CITY, UT 841243550
Phone: (888) 949-4864
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $240.
Total Amount is formed as General ($240) + Research ($0) + Ownership ($0) = $240.
Last reported payment date: 2024-03-05 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($172).
Total Amount
$240
General + Research + Ownership
Payments
8
Total payment records
General Amount
$240
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Pharmaceuticals, Inc | $172 |
| ABBVIE INC. | $22 |
| Vanda Pharmaceuticals Inc. | $17 |
| Indivior Inc. | $15 |
| Beckman Coulter, Inc. | $14 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-09-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20150129002213 | I | Nurse Practitioner | UT | TBD |
| I20220930002350 | I | Nurse Practitioner | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 41 | 14 | $0 |
Insurance plans in this area (ZIP 83617)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | UT | |
| - | UT | |
| - | UT | |
| - | UT | |
| - | UT | |
| - | UT | |
| - | UT | |
| Clinical Social Worker | MO | |
| Clinical Social Worker | UT | |
| - | UT |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.