Active NPI
Ammon Haymond
- Psychiatric/Mental Health Nurse Practitioner
- St George, UT
National Provider Identifier
1700237740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 9611455-4405
- Practice address
- 2276 E Riverside Dr
St George, UT 84790-2636 - Phone
- (435) 986-2565
- NPI assigned
- Jun 30, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 9611455-4405 | UT | Primary |
Addresses
Primary practice location
2276 E Riverside Dr
St George, UT 84790-2636
Mailing address
2276 E Riverside Dr
St George, UT 84790-2636
Phone (435) 986-2565
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2026
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2276 E Riverside Dr
St George, UT 84790-2636
5217 S State St
Suite 201
Murray, UT 84107-4812
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9611455-4405 | UT | MD | Psychiatric/Mental Health Nurse Practitioner |
Organizations & group practices 1
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.
-
dba Fourth Street Clinic
- Federally Qualified Health Center (FQHC)
- Salt Lake City, UT
- NPI 1528128899
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775001600000",
"number": "1700237740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2276 E RIVERSIDE DR",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847902636",
"telephone_number": "435-986-2565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2276 E RIVERSIDE DR",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847902636",
"telephone_number": "435-986-2565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYMOND",
"first_name": "AMMON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-30",
"last_updated": "2026-04-01",
"certification_date": "2026-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "UT",
"license": "9611455-4405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St George, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.