Active NPI
Nusrat Ahmed, M.D.
- Psychiatry Physician
- Salt Lake City, UT
National Provider Identifier
1497739387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 1741651205
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| U003 | Other | UT | EDUCATORS MUTUAL |
| U006 | Other | UT | INTERMOUNTAIN HEALTH CARE |
| RCAR | Other | UT | RAILROAD MEDICARE |
| U002 | Other | UT | DESERET MUTUAL |
| U009 | Other | UT | CHAMPUS |
| U001 | Other | UT | BLUE 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
| License | State | Type | Specialty |
|---|---|---|---|
| 1741651205 | UT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- West Valley City, UT
- NPI 1932166980
Psychiatry
-
- Geriatric Psychiatry Physician
- Salt Lake City, UT
- NPI 1366408874
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.