Nutrix Utah PC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

NUTRIX UTAH PC

Practice address

6621 W Wide Hollow Dr
Herriman, UT 84096-3550

Phone

(801) 425-2831

NPI assigned

Nov 2, 2023

Organization subpart

No

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

Authorized official

Name

Jesse Goodman, AGPCNP-BC, PMHNPNPI 1609248202

Title

President/Owner

Phone

(801) 425-2831

Specialties & licenses 1

Addresses

Tax ID family

Nutrix Utah PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Nutrix Utah PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Herriman, UT
  • NPI 1396689998
  NPD tax ID

Practitioners 1

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

• Jesse Goodman, AGNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Irvine, CA
  • NPI 1609248202
  NPD Authorized official

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1487427340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6621 W WIDE HOLLOW DR",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840963550",
            "telephone_number": "801-425-2831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 W WIDE HOLLOW DR",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840963550",
            "telephone_number": "801-425-2831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRIX UTAH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-02",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "801-425-2831",
        "authorized_official_credential": "AGPCNP-BC, PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jed C. Nordfelt, D.M.D.
• Cassidy L Nordhoff, CMHC
• Mylinda Nunes, RN, IBCLC
• Florencia Nunez
• Nutrix Utah PC
• Chelsea Ann Oliver, MTRC, CTRS
• Onpoint Medical Solutions LLC
• Oragen in-House Surgery LLC
• Madalyn Angusmarie Ordonez
• Shaylee Amber Orr

• Psychiatric/Mental Health Nurse Practitioner in Herriman, UT
• Providers in Herriman, UT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.