Individual provider Active NPI

Scott Osabuohien, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Draper, UT
National Provider Identifier
1376281477
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10396284-4405 Issued in UT
Practice address
721 E 12200 S
Draper, UT 84020-9723
Phone
(810) 369-8989
NPI assigned
May 27, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10396284-4405 UT Primary

Addresses

Primary practice location

721 E 12200 S
Draper, UT 84020-9723

Mailing address

721 E 12200 S
Draper, UT 84020-9723
Phone (801) 369-8989

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
I20220615001102 UT Practitioner - Nurse Practitioner 6305225715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Numinus Wellness Ut IncGroup PAC ID 2163750688, 50 clinicians

Practice addresses (Care Compare)

672 W 400
Suite 201
Springville, UT 84663-3170
Phone (801) 369-8989

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10396284-4405UTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Numinus Wellness Ut Inc CurrentSince Jun 3, 2022 Accepting new patients

Locations

721 E 12200 S
#101
Draper, UT 84020

672 W 400 S
Ste 201
Springville, UT 84663
Phone (208) 680-8226

Interoperability endpoints

  • Direct secure messaging: scott.osabuohien.1@17324.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1653609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1376281477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 E 12200 S",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840209723",
            "telephone_number": "801-369-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 E 12200 S",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840209723",
            "telephone_number": "810-369-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSABUOHIEN",
        "first_name": "SCOTT",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-27",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "10396284-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

Verify at the official NPI Registry.