Shane Emeron Carter, PMHNP, APRN

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

5710757-4405 Issued in UT

Practice address

4516 S 700 E Ste 370
Murray, UT 84107-8317

Phone

(435) 776-5909

Fax

(435) 776-5909

NPI assigned

Oct 6, 2022

Last updated

Aug 30, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain Mental Health LLCGroup PAC ID 7416314760, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mountain Mental Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Salt Lake City, UT
  • NPI 1588378442

  Psychiatry

  Medicare reassignment Care Compare group NPD Authorized official
• Ampelis Health at Mindful Medical

  • Psychiatry Physician
  • South Ogden, UT
  • NPI 1942936091
  NPD (past)
• Ampelis Health Highland

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Highland, UT
  • NPI 1003588369

  Psychiatry

  NPD (past)

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1245955822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4516 S 700 E STE 370",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841078317",
            "telephone_number": "801-918-1786",
            "fax_number": "385-449-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4516 S 700 E STE 370",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841078317",
            "telephone_number": "435-776-5909",
            "fax_number": "435-776-5909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "SHANE",
        "middle_name": "EMERON",
        "credential": "PMHNP, APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-06",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "5710757-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel J. Carson, DO
• Jody L. Carter, APRN
• Mackenzie Carter, MOT, OTR/L
• Matthew Alan Carter, MD
• Sean Carter
• Chelsie Casaus
• Brynley Case, MSW, CSW
• Mary Michelle Cashman Thomas, MSN, APRN-BC, ACNP
• Andreina Caslow
• John Trent Casper, MPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.

Verify at the official NPI Registry.