KAITLIN ELLISON (APRN) – Women's Health Nurse Practitioner, NPI 1730864786

KAITLIN ELLISON (APRN) is a healthcare provider. based in South ogden, Utah. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 10385255-4405 (UT). The NPI Number for KAITLIN ELLISON (APRN) is 1730864786

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
KAITLIN ELLISON (APRN)
NPI
1730864786
Phone
(801) 337-5800
Address
1525 E 6000 S
Enumeration Date
19 June 2023
Last Update Date
19 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8013375800
Graduation Year
2023 (3 years ago)
PAC ID
5799147484
Group Practice PAC ID
5193703544
Professional Enrollment ID
I20230811001997
Address ID
UT844057149OG1525X6000301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

2,655 NURSE PRACTITIONER in UT

Provider Addresses for KAITLIN ELLISON (APRN)

  • 1525 E 6000 S

    SOUTH OGDEN, UT 844057144

    Phone: (801) 337-5800

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $61.

Total Amount is formed as General ($61) + Research ($0) + Ownership ($0) = $61.

Last reported payment date: 2024-11-06 • Largest payer in this snapshot: Becton, Dickinson and Company ($16).

Total Amount

$61

General + Research + Ownership

Payments

4

Total payment records

General Amount

$61

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-06

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2023-08-11

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
I20230811001997INurse 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 84405)

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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: 5193703544View full group profile
NameSpecialtyState
-UT
Nurse PractitionerUT
O B S T E T R I C S/ G Y N E C O L O G YUT
O B S T E T R I C S/ G Y N E C O L O G YUT
-UT
O B S T E T R I C S/ G Y N E C O L O G YUT
O B S T E T R I C S/ G Y N E C O L O G YUT
Certified Nurse Midwife (Cnm)UT
O B S T E T R I C S/ G Y N E C O L O G YUT
-UT

Reviews

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Frequently asked questions

Can I use this page to confirm KAITLIN ELLISON (APRN)'s NPI?
Yes. KAITLIN ELLISON (APRN) is listed with NPI 1730864786 in the public NPI dataset.
Is KAITLIN ELLISON (APRN) still practicing?
KAITLIN ELLISON (APRN) is currently listed as active in the public NPI registry.
What taxonomy line describes KAITLIN ELLISON (APRN)?
For research purposes, treat KAITLIN ELLISON (APRN) as Women's Health Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Where is KAITLIN ELLISON (APRN) based?
KAITLIN ELLISON (APRN) is tied to South Ogden, Utah in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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