Adam Phillip Pendleton, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

10824745-1205 Issued in UT

Practice address

6550 S Millrock Dr Ste 125
Holladay, UT 84121-5794

Phone

(801) 821-2333

Fax

(801) 901-1194

NPI assigned

Apr 10, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Salt Lake Behavioral Health, LLC

  • Psychiatric Hospital
  • Salt Lake City, UT
  • NPI 1295066116
  Medicare reassignment NPD
• Salt Lake Behavioral Health, LLC

  • Addiction Medicine (Family Medicine) Physician
  • Salt Lake City, UT
  • NPI 1689037566
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1013350982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 N TRIUMPH BLVD STE 500",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840436475",
            "telephone_number": "801-821-2781",
            "fax_number": "801-901-1194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 S MILLROCK DR STE 125",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841215794",
            "telephone_number": "801-821-2333",
            "fax_number": "801-901-1194"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2989 W Maple Loop Dr Ste 230",
            "address_purpose": "LOCATION",
            "city": "Lehi",
            "state": "UT",
            "postal_code": "840437415",
            "country_code": "US",
            "telephone_number": "801-821-2333",
            "fax_number": "801-901-1194",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3300 N Triumph Blvd Ste 500",
            "address_purpose": "LOCATION",
            "city": "Lehi",
            "state": "UT",
            "postal_code": "840436475",
            "country_code": "US",
            "telephone_number": "801-821-2333",
            "fax_number": "801-901-1194",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4905 S 1500 W",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "UT",
            "postal_code": "84405",
            "country_code": "US",
            "telephone_number": "801-821-2781",
            "fax_number": "801-901-1194",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4919 S 1500 W",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "UT",
            "postal_code": "84405",
            "country_code": "US",
            "telephone_number": "801-821-2781",
            "fax_number": "801-901-1194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENDLETON",
        "first_name": "ADAM",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-10",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "10824745-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• P I C Incorporated
• Jeremy Pack
• Palliative Medicine Associates LLC
• Matthew D Pearson, MD
• Alyssa Peiffer
• Brynnly Collett Peterlin
• Richard Kyle Petersen
• Julia Peterson, CSW
• Bryn Petron
• Trisha Lynne Phaklides, L.AC.

• Psychiatry Physician in Holladay, UT
• Providers in Holladay, UT by specialty
• Psychiatry Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.