Individual provider Active NPI

Susan Marie Wiet, M.D.

  • Psychiatry Physician
  • Salt Lake City, UT
National Provider Identifier
1770597726
Registry record updated Apr 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
371106 Issued in UT
Practice address
160 S 1000 E Ste 220
Salt Lake City, UT 84102-1552
Phone
(978) 743-9438
Fax
(844) 838-8100
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2018

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 371106 UT Primary

Addresses

Primary practice location

160 S 1000 E Ste 220
Salt Lake City, UT 84102-1552

Mailing address

850 E 300 S Ste 1
Salt Lake City, UT 84102-2301
Phone (385) 429-9808

Other identifiers 3

IdentifierTypeStateIssuer
37110612001001OtherUTBLUE CROSS BLUE SHIELD
70927OtherUTPUBLIC EMPLOYEES HEALTH P
870663870SW2OtherUTEMIA

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
I20070103000350 UT Practitioner - Psychiatry 1850391582 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
371106UTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TMS Solutions Inc Psychiatry CurrentSince Jul 17, 2019 Accepting new patients
Valley Behavioral Health Incorporated Psychiatry Past Accepting new patients

Locations

2646 Patterson Rd
Ste B
Grand Junction, CO 81506
Phone (970) 241-1983

5117 S 1500 W
Riverdale, UT 84405

850 E 300 S
Ste 1
Salt Lake Cty, UT 84102
Phone (385) 429-9808

765 E Holland Ave
Ste 1
Spokane, WA 99218
Phone (509) 242-6005

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1770597726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 E 300 S STE 1",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022301",
            "telephone_number": "385-429-9808",
            "fax_number": "844-838-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 S 1000 E STE 220",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021552",
            "telephone_number": "978-743-9438",
            "fax_number": "844-838-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIET",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "371106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "37110612001001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PUBLIC EMPLOYEES HEALTH P",
            "identifier": "70927",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMIA",
            "identifier": "870663870SW2",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.