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Active NPI 1417783325 Individual Practitioner Female Practitioner

Staci Ann Willis , FNP

Nurse Practitioner • Ogden, UT

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Staci Willis, FNP is a certified Nurse Practitioner practicing in Ogden, UT. With approximately 2 years of clinical experience since completing medical education in 2024, Staci Willis delivers high-quality medical care to the local community at 4403 HARRISON BLVD STE 4410.

Staci Willis is affiliated with Ihc Health Services Inc and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

4403 Harrison Blvd Ste 4410

Ogden, UT 844033323

Telephone 8013876850
Associated Practice Facility / Clinic
🏢 Intermountain Healthcare Facility NPI 1326096728

Medicare Profile & Education

Medical School

Other

Graduation Year

2024

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Ogden, UT

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
2 Yrs -7.8 yrs vs City Avg
City Avg: 9.8 Yrs
State Avg: 8.4 Yrs
Regional Practice Density
86 Specialists

Practicing in Ogden, UT (1143 Statewide)

Telehealth Adoption Rate
20.9% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Willis (2 Years) 2 Yrs
Ogden Specialty Average (9.8 Years) 9.8 Yrs

Medical Specialties & State Licenses

CMS Verified: 2026-05-22
Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License UT 365799-4405

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Hospital & Practice Group Affiliations

Ihc Health Services Inc

4403 Harrison Blvd, Ogden, UT 844033323

Phone: 8013878290

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. Haley Belt , MD

Internal Medicine - Pulmonary Disease

NPI 1053940080

Doctor of Medicine (M.D.)

Kortnee Brightshue

Nurse Practitioner

NPI 1285364570

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Business Mailing Address February 13, 2025

Registered at PO BOX 27128, SALT LAKE CITY, UT 841270128

📍
Updated Practice Location December 11, 2024

Registered at 4403 HARRISON BLVD STE 4410, OGDEN, UT 844033323 (Tel: 8018707308)

📍
Updated Business Mailing Address December 11, 2024

Registered at 4403 HARRISON BLVD STE 4410, OGDEN, UT 844033323 (Tel: 8018707308)

NPI Profile Active September 09, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location September 09, 2024

Registered at 28 COUNTRYSIDE RD, FARMINGTON, UT 840255021 (Tel: 8018707308)

📍
Updated Business Mailing Address September 09, 2024

Registered at 28 COUNTRYSIDE RD, FARMINGTON, UT 840255021 (Tel: 8018707308)

👤
Provider Name / Credentials Updated September 09, 2024

Recorded as STACI WILLIS, FNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 09, 2024

Nurse Practitioner (License #365799-4405 in UT)

🟢
Initial NPI Registration & Enumeration September 09, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1417783325
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 09, 2024
Last Update: May 22, 2026
Sole Proprietor: No

Mailing Address

Po Box 27128

Salt Lake City, UT 841270128

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.