NPIMap

Organization Active NPI

Integrated TMS LLC

  • Psychiatry Physician
  • Saint George, UT
National Provider Identifier
1336718204
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
INTEGRATED TMS LLC
Practice address
1664 S Dixie Dr Ste 102
BLD E
Saint George, UT 84770-7327
Phone
(435) 767-8840
Fax
(435) 703-6003
NPI assigned
Jun 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Authorized official

Name
Forrest Jim Wolverton
Title
Owner/Director
Phone
(435) 767-8840

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

1664 S Dixie Dr Ste 102
BLD E
Saint George, UT 84770-7327

Mailing address

1664 S Dixie Dr Ste 102
BLD E
Saint George, UT 84770-7327
Phone (435) 767-8840

Other identifiers 2

IdentifierTypeStateIssuer
1972846384MedicaidUT
1730125956MedicaidUT

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL forrest@integratedtms.com Direct Alberto Souza, PLLC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624838400000",
    "number": "1336718204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1664 S DIXIE DR STE 102",
            "address_2": "BLD E",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847707327",
            "telephone_number": "435-767-8840",
            "fax_number": "435-703-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1664 S DIXIE DR STE 102",
            "address_2": "BLD E",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847707327",
            "telephone_number": "435-767-8840",
            "fax_number": "435-703-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED TMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A",
        "authorized_official_last_name": "WOLVERTON",
        "authorized_official_first_name": "FORREST",
        "authorized_official_middle_name": "JIM",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "435-767-8840"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972846384",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730125956",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "forrest@integratedtms.com",
            "affiliation": "Y",
            "endpointDescription": "Business URL Email",
            "affiliationName": "Alberto Souza, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1664 S Dixie Dr Ste 102",
            "address_2": "Bld E",
            "city": "Saint George",
            "state": "UT",
            "country_code": "US",
            "postal_code": "847707327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.