Active NPI
Brent L Griffin, MD
- Psychiatry Physician
- Provo, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 1619961205
- Practice address
- 1034 N 500 W
Provo, UT 84604-3380 - Phone
- (801) 357-4542
- NPI assigned
- Jul 20, 2006
- Last updated
- Aug 12, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 1619961205 | UT | Primary |
Addresses
Primary practice location
1034 N 500 W
Provo, UT 84604-3380
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 357-4542
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | brent.griffin@direct.imail.org |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- University of Texas Medical School at Houston, 1974
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
East Hwy 262
Montezuma Creek, UT 84534-0130
Phone (435) 651-3700
PO Box
Montezuma Creek, UT 84534
PO Box
Montezuma Creek, UT 84534-0130
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1619961205 | UT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Utah State Developmental Center | Current | Accepting new patients | |
| State of Utah | Current | Accepting new patients | |
| Utah Navajo Health System, Incorporated | Current | Accepting new patients | |
| Wasatch Behavioral Health Special Service District | Past | Accepting new patients | |
| Utah Navajo Health System, Incorporated | Past | Accepting new patients | |
| Utah Navajo Health System, Incorporated | Past | Accepting new patients | |
| Wasatch Behavioral Health Special Service District | Past | Accepting new patients |
Locations
895 N 900 E
American Fork, UT 84003
Phone (801) 756-6022
Interoperability endpoints
- brent.griffin.1@16098.direct.athenahealth.com
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Montezuma Creek Community Health Center
- Federally Qualified Health Center (FQHC)
- Montezuma Creek, UT
- NPI 1811991151
-
- Mental Illness Intermediate Care Facility
- American Fork, UT
- NPI 1689674301
-
dba Blanding Family Practice Community Health Center
- Family Medicine Physician
- Blanding, UT
- NPI 1457489486
-
- Land Ambulance
- Montezuma Creek, UT
- NPI 1598198434
-
- Community/Behavioral Health Agency
- Provo, UT
- NPI 1356357115
-
- Clinical Medical Laboratory
- Orem, UT
- NPI 1669257556
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628726400000",
"number": "1023038114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27128",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841270128",
"telephone_number": "801-357-4542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1034 N 500 W",
"city": "PROVO",
"state": "UT",
"postal_code": "846043380",
"telephone_number": "801-357-4542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIFFIN",
"first_name": "BRENT",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-20",
"last_updated": "2021-08-12",
"certification_date": "2021-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "UT",
"license": "1619961205",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "brent.griffin@direct.imail.org",
"affiliation": "N",
"address_1": "1034 N 500 W",
"city": "Provo",
"state": "UT",
"country_code": "US",
"postal_code": "846043380",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.