Individual provider Active NPI

Janice M Trump, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bountiful, UT
National Provider Identifier
1205308780
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10015740 Issued in OR
Practice address
630 Medical Dr
Bountiful, UT 84010-4908
Phone
(801) 299-3781
NPI assigned
Dec 21, 2018
Last updated
Dec 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 377875-4405 UT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10015740 OR Primary

Addresses

Primary practice location

630 Medical Dr
Bountiful, UT 84010-4908

Mailing address

PO Box 742353
Atlanta, GA 30374-2353

Other practice location 1

831 NW Council Dr Ste 125
Gresham, OR 97030-3794
Phone (503) 665-8176

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190329001990 UT Practitioner - Nurse Practitioner 4981945979 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Partners for Mental Health LLCGroup PAC ID 2860914918, 5 clinicians
Mountainstar Behavioral Health LLCGroup PAC ID 1052558186, 13 clinicians

Practice addresses (Care Compare)

240 N E Promontory
Suite 233
Farmington, UT 84025
Phone (801) 923-2317

630 Medical Dr
Bountiful, UT 84010-4908
Phone (801) 299-2200

Merit-based Incentive Payment System (MIPS)

Final score
92 of 100Reported as group
Quality
84.7
Promoting interoperability
100
Improvement activities
40
Cost
79.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10015740ORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Nov 9, 2021 Accepting new patients
Ihc Health Services Inc CurrentSince Nov 9, 2021 Accepting new patients
Mountainstar Behavioral Health LLC CurrentSince Feb 1, 2019 Accepting new patients
Portland Adventist Medical Center CurrentSince Oct 16, 2023 Accepting new patients
Partners for Mental Health LLC Psychiatric/Mental Health CurrentSince Jan 18, 2025 Accepting new patients
Portland Adventist Medical Center CurrentSince Oct 16, 2023 Accepting new patients
Ihc Health Services Inc Current Accepting new patients

Locations

10151 SE Sunnyside Rd
Ste 100
Clackamas, OR 97015
Phone (503) 659-0880

831 NW Council Dr
Ste 125
Gresham, OR 97030
Phone (503) 661-3439

1700 SW 257th Ave
Troutdale, OR 97060
Phone (503) 669-6800

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

240 N East Promontory
Ste 233
Farmington, UT 84025
Phone (801) 923-2317

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

630 Medical Dr
North Salt Lake, UT 84010
Phone (801) 292-6231

1000 E 100 N
Payson, UT 84651
Phone (801) 465-7000

5373 S Green St
Ste 400
Salt Lake City, UT 84123
Phone (801) 442-2615

Interoperability endpoints

  • Direct secure messaging: janice.trump@hca3.eclinicaldirectplus.com
  • Direct secure messaging: jtrump165799@direct.ohsu.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1545350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1205308780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742353",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 MEDICAL DR",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104908",
            "telephone_number": "801-299-3781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "831 NW Council Dr Ste 125",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "970303794",
            "country_code": "US",
            "telephone_number": "503-665-8176",
            "fax_number": "503-665-8178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUMP",
        "first_name": "JANICE",
        "middle_name": "M",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-21",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "377875-4405",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10015740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

Verify at the official NPI Registry.