Individual provider Active NPI

Nusrat Ahmed, M.D.

  • Psychiatry Physician
  • Salt Lake City, UT
National Provider Identifier
1497739387
Registry record updated Aug 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
1741651205 Issued in UT
Practice address
1020 S Main St
Suit #100
Salt Lake City, UT 84101-3176
Phone
(801) 572-0133
Fax
(801) 539-7050
NPI assigned
Dec 3, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 1741651205 UT Primary

Addresses

Primary practice location

1020 S Main St
Suit #100
Salt Lake City, UT 84101-3176

Mailing address

46 Lone Holw
Sandy, UT 84092-5530
Phone (801) 572-0133

Other identifiers 6

IdentifierTypeStateIssuer
U003OtherUTEDUCATORS MUTUAL
U006OtherUTINTERMOUNTAIN HEALTH CARE
RCAROtherUTRAILROAD MEDICARE
U002OtherUTDESERET MUTUAL
U009OtherUTCHAMPUS
U001OtherUTBLUE CROSS

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1741651205UTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Mental Health Incorporated Past Accepting new patients
Valley Behavioral Health Incorporated Psychiatry Past Accepting new patients

Organizations & group practices 2

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": "1133568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344902400000",
    "number": "1497739387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 LONE HOLW",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840925530",
            "telephone_number": "801-572-0133",
            "fax_number": "801-539-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 S MAIN ST",
            "address_2": "SUIT #100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841013176",
            "telephone_number": "801-572-0133",
            "fax_number": "801-539-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "NUSRAT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-03",
        "last_updated": "2012-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "1741651205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDUCATORS MUTUAL",
            "identifier": "U003",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERMOUNTAIN HEALTH CARE",
            "identifier": "U006",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "RCAR",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DESERET MUTUAL",
            "identifier": "U002",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "U009",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "U001",
            "state": "UT"
        }
    ],
    "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 14, 2012; 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.