Active NPI 1306034616 Individual Practitioner Male Practitioner

Kerry R Reynolds , PA-C

Physician Assistant • Ogden, UT

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Kerry Reynolds, PA-C is a certified Physician Assistant practicing in Ogden, UT. With approximately 19 years of clinical experience since completing medical education in 2007, Kerry Reynolds delivers high-quality medical care to the local community at 698 12TH ST.

Kerry Reynolds is affiliated with Ogden Clinic Pc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's, insertion of needle into vein for collection of blood sample. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

698 12th St

Ogden, UT 844046200

Telephone 8014753700

Fax 8014753701

Associated Practice Facility / Clinic

🏢 12th St Pharmacy Inc Facility NPI 1538284716

Medicare Profile & Education

Medical School

Other

Graduation Year

2007

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Ogden, UT

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

19 Yrs +6.5 yrs vs City Avg

City Avg: 12.5 Yrs

State Avg: 12.1 Yrs

Regional Practice Density

112 Specialists

Practicing in Ogden, UT (1904 Statewide)

Telehealth Adoption Rate

4.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

47.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Reynolds (19 Years) 19 Yrs

Ogden Specialty Average (12.5 Years) 12.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	142	87	$182.00	$100.01
99213 Established patient office or other outpatient visit, typically 15 minutes	114	83	$133.00	$71.51
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	99	54	$24.00	$12.60
36415 Insertion of needle into vein for collection of blood sample	97	58	$7.00	$6.75
80053 Blood test, comprehensive group of blood chemicals	56	44	$27.00	$10.35
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	56	45	$14.00	$7.40
83036 Hemoglobin A1C level	50	37	$24.00	$9.33
84443 Blood test, thyroid stimulating hormone (TSH)	44	39	$42.00	$16.17
80061 Blood test, lipids (cholesterol and triglycerides)	29	28	$33.00	$13.12
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	23	11	$37.00	$10.49
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza	23	20	$100.00	$68.88
87086 Bacterial colony count, urine	23	20	$20.00	$7.37
81001 Manual urinalysis test with examination using microscope, automated	23	21	$8.00	$2.79
82607 Cyanocobalamin (vitamin B-12) level	21	19	$39.00	$14.78
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	21	21	$171.00	$104.22
81002 Urinalysis, manual test	21	19	$8.00	$3.41
82306 Vitamin d-3 level	20	18	$73.00	$29.01
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	15	15	$167.00	$90.34

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	150	102	$182.00	$102.43
36415 Insertion of needle into vein for collection of blood sample	127	78	$7.00	$6.81
99213 Established patient office or other outpatient visit, typically 15 minutes	125	91	$133.39	$72.00
80053 Blood test, comprehensive group of blood chemicals	69	53	$27.00	$10.35
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	67	51	$14.00	$7.61
83036 Hemoglobin A1C level	49	38	$24.00	$9.37
84443 Blood test, thyroid stimulating hormone (TSH)	43	42	$42.00	$16.46
80061 Blood test, lipids (cholesterol and triglycerides)	34	31	$33.00	$13.12
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	31	19	$37.00	$11.03
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	26	26	$171.00	$104.17
81001 Manual urinalysis test with examination using microscope, automated	24	22	$8.00	$3.00
82607 Cyanocobalamin (vitamin B-12) level	23	19	$39.00	$14.78
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza	23	23	$100.00	$55.36
87086 Bacterial colony count, urine	20	17	$20.00	$7.91
82306 Vitamin d-3 level	18	17	$73.00	$29.01
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	15	15	$30.00	$16.20
87186 Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution	15	14	$21.00	$8.48
87088 Bacterial urine culture	13	12	$18.00	$7.93
81002 Urinalysis, manual test	12	11	$8.00	$3.41
90662 Influenza vaccine split virus, preservative free	11	11	$80.00	$71.31
G0008 Administration of influenza virus vaccine	11	11	$32.00	$24.93

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	131	104	$127.08	$72.26
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	126	87	$178.78	$103.82
36415 Insertion of needle into vein for collection of blood sample	116	71	$7.00	$2.96
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	64	54	$14.00	$7.67
80053 Blood test, comprehensive group of blood chemicals	63	50	$27.00	$10.43
84443 Blood test, thyroid stimulating hormone (TSH)	50	45	$42.00	$16.59
83036 Hemoglobin A1C level	46	33	$24.00	$9.57
82306 Vitamin d-3 level	38	33	$73.00	$29.27
81001 Manual urinalysis test with examination using microscope, automated	32	29	$8.00	$3.13
80061 Blood test, lipids (cholesterol and triglycerides)	28	26	$33.00	$13.20
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	26	26	$171.00	$106.27
82607 Cyanocobalamin (vitamin B-12) level	21	21	$39.00	$14.84
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	20	20	$162.45	$91.60
87086 Bacterial colony count, urine	20	19	$20.00	$7.96
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza	16	16	$100.00	$30.57
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	15	14	$30.00	$16.41
G0008 Administration of influenza virus vaccine	14	14	$32.00	$24.29
87088 Bacterial urine culture	13	12	$18.00	$7.97
87186 Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution	13	12	$21.00	$8.52
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	13	13	$75.00	$50.76
81002 Urinalysis, manual test	12	11	$8.00	$3.44
83540 Iron level	12	12	$16.00	$6.38
90662 Influenza vaccine split virus, preservative free	12	12	$80.00	$68.54
83550 Iron binding capacity	11	11	$22.00	$8.62

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	171	126	$102.00	$74.62
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	168	118	$153.00	$104.03
36415 Insertion of needle into vein for collection of blood sample	157	102	$7.00	$3.00
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	105	80	$14.00	$7.77
80053 Blood test, comprehensive group of blood chemicals	101	85	$27.00	$10.56
84443 Blood test, thyroid stimulating hormone (TSH)	64	59	$42.00	$16.80
83036 Hemoglobin A1C level	55	46	$24.00	$9.71
81001 Manual urinalysis test with examination using microscope, automated	43	38	$8.00	$3.17
82306 Vitamin d-3 level	43	39	$73.00	$29.60
80061 Blood test, lipids (cholesterol and triglycerides)	40	40	$33.00	$13.39
82607 Cyanocobalamin (vitamin B-12) level	39	34	$39.00	$15.08
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	37	21	$37.00	$11.55
87086 Bacterial colony count, urine	28	25	$20.00	$8.07
83550 Iron binding capacity	26	24	$22.00	$8.74
83540 Iron level	26	24	$16.00	$6.47
82728 Ferritin (blood protein) level	25	22	$36.00	$13.63
81002 Urinalysis, manual test	23	22	$8.00	$3.48
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	23	23	$171.00	$108.55
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	22	22	$154.00	$92.17
G0008 Administration of influenza virus vaccine	20	20	$30.00	$13.98
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza	19	19	$100.00	$63.59
90662 Influenza vaccine split virus, preservative free	18	18	$80.00	$61.63
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	17	17	$30.00	$16.53
87088 Bacterial urine culture	15	15	$18.00	$8.09
87186 Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution	15	15	$21.00	$8.65
82043 Urine microalbumin (protein) level	15	14	$20.00	$5.78
82570 Creatinine level to test for kidney function or muscle injury	15	14	$11.00	$5.18
84439 Thyroxine (thyroid chemical), free	13	12	$22.00	$9.02
G0103 Prostate cancer screening; prostate specific antigen test (psa)	12	12	$40.00	$19.31
0064A Adm sarscov2 50mcg/0.25mlbst	12	12	$41.00	$32.23

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	244	146	$153.00	$87.58
36415 Insertion of needle into vein for collection of blood sample	168	98	$7.00	$2.98
99213 Established patient office or other outpatient visit, typically 15 minutes	125	99	$102.00	$61.84
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	114	83	$14.00	$7.66
80053 Blood test, comprehensive group of blood chemicals	103	79	$27.00	$10.42
84443 Blood test, thyroid stimulating hormone (TSH)	66	60	$42.00	$16.68
83036 Hemoglobin A1C level	62	46	$24.00	$9.66
81001 Manual urinalysis test with examination using microscope, automated	58	51	$8.00	$3.16
80061 Blood test, lipids (cholesterol and triglycerides)	47	47	$33.00	$13.31
G0008 Administration of influenza virus vaccine	32	32	$30.00	$16.20
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	30	30	$171.00	$95.35
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	30	21	$37.00	$10.95
90662 Influenza vaccine split virus, preservative free	28	28	$80.00	$58.37
87086 Bacterial colony count, urine	28	24	$20.00	$8.04
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	26	23	$75.00	$51.31
83540 Iron level	22	16	$16.00	$6.43
82607 Cyanocobalamin (vitamin B-12) level	22	18	$39.00	$14.46
83550 Iron binding capacity	22	16	$22.00	$8.69
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	22	21	$30.00	$15.84
82728 Ferritin (blood protein) level	21	16	$36.00	$13.54
81002 Urinalysis, manual test	20	18	$8.00	$3.46
87081 Screening test for pathogenic organisms	19	18	$15.00	$6.29
87186 Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution	19	17	$21.00	$8.61
82570 Creatinine level to test for kidney function or muscle injury	17	15	$11.00	$5.14
82043 Urine microalbumin (protein) level	17	15	$20.00	$5.73
87088 Bacterial urine culture	16	15	$18.00	$8.04
82306 Vitamin d-3 level	13	12	$73.00	$29.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	335	207	$153.00	$88.99
36415 Insertion of needle into vein for collection of blood sample	208	123	$7.00	$2.93
99213 Established patient office or other outpatient visit, typically 15 minutes	173	114	$102.00	$60.40
80053 Blood test, comprehensive group of blood chemicals	133	103	$27.00	$11.51
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	128	101	$14.00	$8.46
83036 Hemoglobin A1C level	96	79	$24.00	$10.57
84443 Blood test, thyroid stimulating hormone (TSH)	96	83	$42.00	$18.16
81001 Manual urinalysis test with examination using microscope, automated	73	62	$8.00	$3.45
J1885 Injection, ketorolac tromethamine, per 15 mg	60	15	$6.00	$0.46
80061 Blood test, lipids (cholesterol and triglycerides)	58	54	$33.00	$14.58
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	56	35	$36.73	$13.04
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	42	42	$171.00	$96.28
87086 Bacterial colony count, urine	36	33	$20.00	$8.79
G0008 Administration of influenza virus vaccine	34	33	$30.00	$15.91
90662 Influenza vaccine split virus, preservative free	31	30	$79.29	$53.04
82607 Cyanocobalamin (vitamin B-12) level	27	25	$39.00	$16.41
87186 Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution	21	19	$21.00	$9.42
87088 Bacterial urine culture	21	19	$18.00	$8.81
82043 Urine microalbumin (protein) level	21	18	$20.00	$6.29
82570 Creatinine level to test for kidney function or muscle injury	21	18	$11.00	$5.63
G0103 Prostate cancer screening; prostate specific antigen test (psa)	19	19	$40.00	$20.03
83550 Iron binding capacity	19	15	$22.00	$9.52
83540 Iron level	19	15	$16.00	$7.05
82728 Ferritin (blood protein) level	18	15	$36.00	$14.85
82306 Vitamin d-3 level	17	17	$73.00	$32.23
84439 Thyroxine (thyroid chemical), free	17	15	$22.00	$9.82
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	14	14	$63.00	$36.29
87081 Screening test for pathogenic organisms	13	11	$15.00	$7.21
G0009 Administration of pneumococcal vaccine	13	13	$30.00	$15.91
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	13	11	$30.00	$16.20
93000 Routine ekg using at least 12 leads including interpretation and report	13	13	$42.00	$14.06
94640 Inhalation treatment for airway obstruction or sputum production	13	13	$33.00	$13.63
90670 Pneumococcal vaccine for injection into muscle	12	12	$222.50	$207.26

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	370	208	$153.00	$88.08
36415 Insertion of needle into vein for collection of blood sample	210	128	$7.00	$2.90
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	123	99	$14.00	$9.32
80053 Blood test, comprehensive group of blood chemicals	123	106	$27.00	$12.74
99213 Established patient office or other outpatient visit, typically 15 minutes	120	90	$102.00	$58.02
J1885 Injection, ketorolac tromethamine, per 15 mg	100	19	$6.00	$0.57
83036 Hemoglobin A1C level	100	86	$24.00	$11.52
84443 Blood test, thyroid stimulating hormone (TSH)	84	76	$42.00	$20.33
80061 Blood test, lipids (cholesterol and triglycerides)	58	54	$33.00	$15.64
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	54	32	$36.00	$16.67
81001 Manual urinalysis test with examination using microscope, automated	53	50	$8.00	$3.78
G0008 Administration of influenza virus vaccine	40	40	$30.00	$19.49
90662 Influenza vaccine split virus, preservative free	34	34	$58.00	$52.30
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	31	31	$171.00	$96.01
87804 Detection test by immunoassay with direct visual observation for influenza virus	24	11	$30.00	$16.22
82570 Creatinine level to test for kidney function or muscle injury	23	22	$11.00	$5.44
82607 Cyanocobalamin (vitamin B-12) level	23	21	$39.00	$18.24
87086 Bacterial colony count, urine	23	21	$20.00	$9.76
82043 Urine microalbumin (protein) level	23	22	$20.00	$6.09
87186 Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution	22	21	$21.00	$10.46
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	21	21	$154.00	$89.60
85651 Red blood cell sedimentation rate, to detect inflammation, non-automated	18	16	$9.00	$4.10
87088 Bacterial urine culture	18	17	$18.00	$9.79
84153 Psa (prostate specific antigen) measurement, total	17	15	$46.00	$20.95
83550 Iron binding capacity	15	12	$22.00	$10.57
83540 Iron level	15	12	$16.00	$7.83
82728 Ferritin (blood protein) level	14	12	$36.00	$16.49
84439 Thyroxine (thyroid chemical), free	14	13	$22.00	$10.91
82306 Vitamin d-3 level	13	12	$73.00	$35.82
83735 Magnesium level	13	11	$23.00	$7.48
99202 New patient office or other outpatient visit, typically 20 minutes	12	12	$102.00	$62.02
G0009 Administration of pneumococcal vaccine	12	12	$30.00	$19.49
G0103 Prostate cancer screening; prostate specific antigen test (psa)	12	12	$40.00	$22.26
93000 Routine ekg using at least 12 leads including interpretation and report	11	11	$42.00	$13.98
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	11	11	$30.00	$16.20

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	281	158	$153.00	$87.86
36415 Insertion of needle into vein for collection of blood sample	214	112	$7.00	$2.94
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	122	89	$14.00	$7.11
83036 Hemoglobin A1C level	112	85	$24.00	$13.05
80053 Blood test, comprehensive group of blood chemicals	107	86	$27.00	$12.72
99213 Established patient office or other outpatient visit, typically 15 minutes	89	69	$102.00	$59.73
84443 Blood test, thyroid stimulating hormone (TSH)	80	69	$42.00	$22.59
J1885 Injection, ketorolac tromethamine, per 15 mg	78	20	$6.00	$0.66
80061 Blood test, lipids (cholesterol and triglycerides)	60	52	$33.00	$14.63
81001 Manual urinalysis test with examination using microscope, automated	50	46	$8.00	$4.26
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	48	30	$36.00	$20.51
87086 Bacterial colony count, urine	28	27	$20.00	$10.85
87186 Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution	25	24	$21.00	$11.62
87088 Bacterial urine culture	24	23	$18.00	$10.88
G0008 Administration of influenza virus vaccine	23	22	$30.00	$23.96
90662 Influenza vaccine split virus, preservative free	22	21	$45.95	$44.54
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	21	21	$171.00	$94.79
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	18	18	$154.00	$89.26
83550 Iron binding capacity	17	14	$22.00	$11.75
83540 Iron level	17	14	$16.00	$8.70
82728 Ferritin (blood protein) level	17	14	$36.00	$18.33
82043 Urine microalbumin (protein) level	16	16	$20.00	$7.77
82607 Cyanocobalamin (vitamin B-12) level	16	15	$39.00	$20.27
82570 Creatinine level to test for kidney function or muscle injury	16	16	$11.00	$5.54
85651 Red blood cell sedimentation rate, to detect inflammation, non-automated	15	13	$9.00	$4.77
84439 Thyroxine (thyroid chemical), free	14	13	$22.00	$11.75
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	14	13	$63.00	$35.73
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	13	12	$30.00	$16.11
94640 Inhalation treatment for airway obstruction or sputum production	12	11	$33.00	$14.57

Medical Specialties & State Licenses

CMS Verified: 2021-05-04

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Hospital & Practice Group Affiliations

Ogden Clinic Pc

698 12th St, Ogden, UT 844046200

Phone: 8014753700

Ogden Clinic Pc

5495 S 500, Ogden, UT 844057409

Phone: 8014753100

Ogden Clinic Pc

6112 S 1550, Ogden, UT 844055007

Phone: 8014753800

Practice Associates & Co-Workers

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

17 Associated Practitioners

Michael Browne , PA-C

Physician Assistant

NPI 1043594567

Physician Assistant (Certified)

Dr. Matthew Naegle , DO

Pediatrics

NPI 1154850477

Doctor of Osteopathic Medicine (D.O.)

Dr. Jason Gubler , DPT

Physical Therapist

NPI 1225486608

Doctor of Physical Therapy

Brittany Kester , PA-C

Physician Assistant

NPI 1265989446

Physician Assistant (Certified)

Dr. Monte Roberts , PhD, DNP, RN

Registered Nurse - School

NPI 1316747595

Doctor of Philosophy (Ph.D.), Doctor of Nursing Practice, Registered Nurse

Karen Vastardis , FNP

Nurse Practitioner

NPI 1487643011

Family Nurse Practitioner

Career & Practice History Timeline

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

12 Historical Events

📍

Updated Practice Location May 04, 2021

Registered at 698 12TH ST, OGDEN, UT 844046200 (Tel: 8014753700)

✅

NPI Profile Active January 17, 2017

NPI status registered as active in NPPES database

📍

Updated Business Mailing Address January 17, 2017

Registered at PO BOX 5546, DENVER, CO 802175546 (Tel: 8014753300)

📍

Updated Practice Location January 17, 2017

Registered at 1159 E 12TH STREET, OGDEN, UT 844045144 (Tel: 8014753700)

👤

Provider Name / Credentials Updated January 17, 2017

Recorded as KERRY REYNOLDS, PA-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 17, 2017

Physician Assistant

✅

NPI Profile Active July 05, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location July 05, 2016

Registered at 1159 E 12TH STREET, OGDEN, UT 844045144 (Tel: 8014753700)

📍

Updated Business Mailing Address July 05, 2016

Registered at 4650 HARRISON BLVD, OGDEN, UT 844034303 (Tel: 8014753000)

👤

Provider Name / Credentials Updated July 05, 2016

Recorded as KERRY REYNOLDS, PA-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 05, 2016

Physician Assistant

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Initial NPI Registration & Enumeration October 11, 2007

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1306034616

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 11, 2007

Last Update: May 04, 2021

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 5546

Denver, CO 802175546

Phone: 8014753300

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

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