NPIMap

Organization Active NPI

University of Utah Pediatric Behavioral Health Services

  • Sports Medicine (Psychiatry & Neurology) Physician
  • Salt Lake City, UT
National Provider Identifier
1467320671
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0010X
Legal business name
UNIVERSITY OF UTAH PEDIATRIC BEHAVIORAL HEALTH SERVICES
Practice address
590 S Wakara Way
Salt Lake City, UT 84108-1200
Phone
(801) 587-7109
NPI assigned
Oct 28, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Authorized official

Name
Jeannine Rushton
Title
Director
Phone
(801) 587-6463

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084S0010X Primary

Addresses

Primary practice location

590 S Wakara Way
Salt Lake City, UT 84108-1200

Mailing address

PO Box 841450
Los Angeles, CA 90084-1450

Other names 1

  • Pediatric Sports Psychiatry Doing business as

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Subparts reporting this organization as parent 13

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

View all 13

Practitioners 116

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160727002309 UT Part B Supplier - Clinic/Group Practice 3870886898 Receives reassigned benefits from 119 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Salt Lake City, UT

National Provider Directory

National Provider Directory
Tax ID family
University of Utah Pediatric Behavioral Health Services7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1761609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761609600000",
    "number": "1467320671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841450",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900841450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 S WAKARA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081200",
            "telephone_number": "801-587-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH PEDIATRIC BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-28",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A",
        "authorized_official_last_name": "RUSHTON",
        "authorized_official_first_name": "JEANNINE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "801-587-6463"
    },
    "taxonomies": [
        {
            "code": "2084S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Sports Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.