TEGAN ELIZABETH SPANGRUDE (DNP) – Family Nurse Practitioner, NPI 1164152997

TEGAN ELIZABETH SPANGRUDE (DNP) is a healthcare provider. based in Salt lake city, Utah. specializing in NURSE PRACTITIONER. They hold the professional credentials DNP. They hold a License No. 9415641-3102 (UT). The NPI Number for TEGAN ELIZABETH SPANGRUDE (DNP) is 1164152997

Main info

Female
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
TEGAN ELIZABETH SPANGRUDE (DNP)
NPI
1164152997
Phone
(801) 664-4462
Address
10 S 2000 E
Enumeration Date
14 June 2022
Last Update Date
8 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8012652000
Graduation Year
2023 (3 years ago)
PAC ID
5890236350
Group Practice PAC ID
7719882562
Professional Enrollment ID
I20241004002217
Address ID
UT841241371SA1250X3900301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:3State licenses:2Digital endpointsOther names

2,655 NURSE PRACTITIONER in UT

Provider Addresses for TEGAN ELIZABETH SPANGRUDE (DNP)

  • 10 S 2000 E

    SALT LAKE CITY, UT 841125880

    Phone: (801) 664-4462

    Type: Location

  • 1018 W RAMBLER DR

    SALT LAKE CITY, UT 841162230

    Phone:

    Type: Mailing

  • 1250 E 3900 S STE 260

    SALT LAKE CITY, UT 841241371

    Phone: (801) 265-2000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-10-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241004002217INurse PractitionerUTTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84112)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7719882562View full group profile

Reviews

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Frequently asked questions

What federal number belongs to TEGAN ELIZABETH SPANGRUDE (DNP)?
The federal identifier for TEGAN ELIZABETH SPANGRUDE (DNP) is NPI 1164152997.
Is TEGAN ELIZABETH SPANGRUDE (DNP) currently active in the NPI registry?
CMS-published data lists TEGAN ELIZABETH SPANGRUDE (DNP) as an active registrant.
What kind of provider is TEGAN ELIZABETH SPANGRUDE (DNP)?
The page reflects Family Nurse Practitioner for TEGAN ELIZABETH SPANGRUDE (DNP). Clinical services aligned with this taxonomy classification.
Where is TEGAN ELIZABETH SPANGRUDE (DNP)'s primary listing?
We display Salt Lake City, Utah because that is what the record indicates for TEGAN ELIZABETH SPANGRUDE (DNP).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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