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KAYLA BLICKENSDERFER
NPI 1124767512
Student in an Organized Health Care Education/Training Program in Salt Lake City, UT

Active since June 02, 2022PECOS Enrolled
1052 E BARBARA PL, SALT LAKE CITY, UT 84102(605) 786-4904 Get Directions Write a Review

NPPES record last updated: June 2, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kayla Blickensderfer NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KAYLA BLICKENSDERFER (NPI 1124767512) is an individual student in an organized health care education/training program in Salt Lake City, Utah and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124767512
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameKAYLA BLICKENSDERFER
Location Address1052 E BARBARA PLSalt Lake City, UT 84102-3111
Mailing Address1052 E Barbara PlSalt Lake City, UT 84102-3111 · (605) 786-4904
Phone(605) 786-4904
Sole ProprietorNo
Enumeration DateJune 2, 2022
NPPES CertifiedJune 2, 2022
✔ NPI 1124767512 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1052 E BARBARA PL, Salt Lake City, UT 84102
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kayla Blickensderfer is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kayla Blickensderfer's NPI number?

The NPI number for Kayla Blickensderfer is 1124767512. It was assigned to this individual provider in the NPPES registry on June 2, 2022.

Where is Kayla Blickensderfer located?

Kayla Blickensderfer practices at 1052 E Barbara Pl, Salt Lake City, UT 84102. The listed phone number is (605) 786-4904.

What is Kayla Blickensderfer's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kayla Blickensderfer enrolled in Medicare?

Yes. Kayla Blickensderfer is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kayla Blickensderfer was last updated on June 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.