Individual provider Active NPI

Ron Matthew Nevin, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Orem, UT
National Provider Identifier
1609625466
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CNP305669 Issued in AZ
Practice address
1125 W Center St
Orem, UT 84057-5207
Phone
(801) 903-5903
NPI assigned
May 15, 2024
Last updated
May 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2024

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 Nurse Practitioner 363LP0808X CNP305669 AZ Primary

Addresses

Primary practice location

1125 W Center St
Orem, UT 84057-5207

Mailing address

5344 S Verde
Mesa, AZ 85212-9116
Phone (480) 273-2823

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

State licenses

LicenseStateTypeSpecialty
CNP305669AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kelly Wosnik Inc CurrentSince May 19, 2024 Accepting new patients
Allred Psychological Services CurrentSince May 19, 2024 Accepting new patients

Locations

1125 W Center St
Orem, UT 84057
Phone (801) 903-5903

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1609625466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5344 S VERDE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852129116",
            "telephone_number": "480-273-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 W CENTER ST",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840575207",
            "telephone_number": "801-903-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVIN",
        "first_name": "RON",
        "middle_name": "MATTHEW",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "CNP305669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.