Individual provider Active NPI

John Perkins

  • Psychologist
  • Salt Lake City, UT
National Provider Identifier
1265097216
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
13571858-2501 Issued in UT
Practice address
322 E 6TH Ave
Salt Lake City, UT 84103-2728
Phone
(612) 590-0600
NPI assigned
May 6, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Student in an Organized Health Care Education/Training Program 390200000X
Psychologist 103T00000X 13571858-2501 UT Primary

Addresses

Primary practice location

322 E 6TH Ave
Salt Lake City, UT 84103-2728

Mailing address

750 N Freedom Blvd
Provo, UT 84601-1677

Other practice location 1

222 SE 8th Ave Ste 212
Hillsboro, OR 97123-4218
Phone (503) 352-7333

Other practice location 2

500 Foothill Dr
Salt Lake City, UT 84148-1677
Phone (801) 582-1565

Other practice location 3

750 N Freedom Blvd
Provo, UT 84601-1677
Phone (801) 373-4760

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241031003079 UT Practitioner - Clinical Psychologist 0749713519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

2075 University Park Blvd
Layton, UT 84041-1611
Phone (801) 387-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13571858-2501UTMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Dec 8, 2024 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Dec 8, 2024 Accepting new patients
Pacific University Past Accepting new patients

Locations

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

435 N Main St
Kaysville, UT 84037
Phone (801) 498-6000

2075 University Park Blvd
Layton, UT 84041
Phone (801) 367-2775

500 Foothill Blvd
Slc, UT 84148
Phone (801) 584-1206

745 S 2000 W
Syracuse, UT 84075
Phone (801) 525-2400

Organizations & group practices 4

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": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1265097216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N FREEDOM BLVD",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 E 6TH AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032728",
            "telephone_number": "612-590-0600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 SE 8th Ave Ste 212",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971234218",
            "country_code": "US",
            "telephone_number": "503-352-7333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Foothill Dr",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841481677",
            "country_code": "US",
            "telephone_number": "801-582-1565",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "750 N Freedom Blvd",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846011677",
            "country_code": "US",
            "telephone_number": "801-373-4760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-06",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "UT",
            "license": "13571858-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.