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University of Utah Behavioral Health Services

Organization Active NPI Psychiatry Physician · Salt Lake City, UT

NPI 1679937700 · NPPES record last updated Sep 9, 2016

Key facts

NPI
1679937700
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatry Physician 2084P0800X
Legal business name
UNIVERSITY OF UTAH BEHAVIORAL HEALTH SERVICES
Practice address
50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone
(801) 587-6336
NPI assigned
Apr 5, 2016
Organization subpart
Yes
Parent organization (as reported)
UNIVERSITY OF UTAH BEHAVIORAL HEALTH SERVICES

Authorized official

Name
Jon Kar Zubieta, MD
Title
Department Chair
Phone
(801) 587-6336

Other NPIs on the same Medicare enrollment 21

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 14

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

  • Lorita L Beiler, MSW, CSW, ACSW Social Worker · Salt Lake City, UT · NPI 1073838066
    NPD
  • Dallas Bowles Psychiatric/Mental Health Nurse Practitioner · Cedar City, UT · NPI 1588154124
    NPD PSYCHIATRY
  • Joshua Stephen Falk, LCSW Clinical Social Worker · Midvale, UT · NPI 1821649443
    NPD
  • Barbara S Faust, PNP Pediatric Nurse Practitioner · Salt Lake City, UT · NPI 1710920566
    NPD
  • Michael Higgins, LCSW Clinical Social Worker · Salt Lake City, UT · NPI 1780038141
    NPD
  • Randi Moore Hollis, FNP Psychiatric/Mental Health Nurse Practitioner · Salt Lake City, UT · NPI 1346642121
    NPD
  • Jeffrey Pedersen, MD Child & Adolescent Psychiatry Physician · Salt Lake City, UT · NPI 1316478290
    NPD
  • Kalyani Samudra, MD Child & Adolescent Psychiatry Physician · Salt Lake City, UT · NPI 1528035748
    NPD PSYCHIATRY
  • Marilyn Ann Schneider, MOT, OTR/L Occupational Therapist · Salt Lake City, UT · NPI 1083134910
    NPD
  • Susan E Scott, FNP-BC Family Nurse Practitioner · South Jordan, UT · NPI 1295044170
    NPD PSYCHIATRY
  • Jordan W Merrill, MD Psychiatry Physician · Eagle, ID · NPI 1902197007
    NPD PSYCHIATRY
  • Michelle Miranda, PHD Clinical Neuropsychologist · Aurora, CO · NPI 1295134070
    NPD NEUROLOGY
  • Jade Rijsketic, PHD Health Psychologist · Redwood City, CA · NPI 1578104378
    NPD
  • Andrew J Smith, PHD Psychologist · Lebanon, NH · NPI 1356821847
    NPD

Medicare participation

Medicare fee-for-service enrollment
Enrolled in UT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20150120001118 UT Part B Supplier - Clinic/Group Practice 9537483607 Receives reassigned benefits from 304 practitioners
21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Salt Lake City, UT; Murray, UT

National Provider Directory

Part of
University of Utah Behavioral Health Services

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084N0400X
Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084P0800X Yes

Addresses

Primary practice location

50 N Medical Dr
Salt Lake City, UT 84132-0001

Mailing address

PO Box 413076
Salt Lake City, UT 84141-3076
Phone (801) 213-3900

Other names

  • Adult Inpatient Program - University Health Care 5 West Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 9, 2016.

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473379200000",
    "number": "1679937700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413076",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841413076",
            "telephone_number": "801-213-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-587-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF UTAH BEHAVIORAL HEALTH SERVICES",
        "enumeration_date": "2016-04-05",
        "last_updated": "2016-09-09",
        "status": "A",
        "authorized_official_last_name": "ZUBIETA",
        "authorized_official_first_name": "JON KAR",
        "authorized_official_title_or_position": "DEPARTMENT CHAIR",
        "authorized_official_telephone_number": "801-587-6336",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adult Inpatient Program - University Health Care 5 West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salt Lake City, UT

All providers in Salt Lake City, UT · Psychiatry Physician in Utah

Sources for this page

Verify at the official NPI Registry.