Individual provider Active NPI

Carl Rasmusen, MD

  • Psychiatry Physician
  • Bountiful, UT
National Provider Identifier
1619048964
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
1809391205 Issued in UT
Practice address
630 E Medical Dr
Bountiful, UT 84010
Phone
(801) 299-3781
Fax
(801) 299-2416
NPI assigned
Nov 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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 1809391205 UT Primary

Addresses

Primary practice location

630 E Medical Dr
Bountiful, UT 84010

Mailing address

PO Box 742353
Atlanta, GA 30374-2353

Other identifiers 1

IdentifierTypeStateIssuer
9670891208001MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040617001072 UT Practitioner - PsychiatryPractitioner - NeurologyPractitioner - Neuropsychiatry 6002890878 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Neurology
Education
University of Alberta, Faculty of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountainstar Behavioral Health LLCGroup PAC ID 1052558186, 13 clinicians

Practice addresses (Care Compare)

630 Medical Dr
Bountiful, UT 84010-4908
Phone (801) 299-2200

Hospital & facility affiliations

  • Lakeview Hospital Hospital, Bountiful, UT, CCN 460042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1809391205UTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Jun 20, 2020 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Mountainstar Behavioral Health LLC CurrentSince Jun 30, 2025 Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

630 Medical Dr
North Salt Lake, UT 84010
Phone (801) 292-6231

1000 E 100 N
Payson, UT 84651
Phone (801) 465-7000

1200 E 3900 S
Slc, UT 84124
Phone (801) 268-7111

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1619048964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742353",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E MEDICAL DR",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "84010",
            "telephone_number": "801-299-3781",
            "fax_number": "801-299-2416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASMUSEN",
        "first_name": "CARL",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "1809391205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9670891208001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

Verify at the official NPI Registry.