Individual provider Active NPI

Carter Smith Syphus, RN, BSN

  • Psychiatric/Mental Health Registered Nurse
  • Salt Lake City, UT
National Provider Identifier
1396463543
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
11926499-3102 Issued in UT
Practice address
500 Foothill Dr
Salt Lake City, UT 84148-0001
Phone
(801) 582-1565
NPI assigned
Aug 15, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 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 Registered Nurse 163WP0808X 11926499-3102 UT Primary

Addresses

Primary practice location

500 Foothill Dr
Salt Lake City, UT 84148-0001

Mailing address

680 W 4800 S
Salt Lake City, UT 84123-4569
Phone (801) 244-7882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
11926499-3102UTMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1396463543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 W 4800 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841234569",
            "telephone_number": "801-244-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FOOTHILL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841480001",
            "telephone_number": "801-582-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYPHUS",
        "first_name": "CARTER",
        "middle_name": "SMITH",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "UT",
            "license": "11926499-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.