Individual provider Active NPI

Tiffany A. Meyer, RN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1780278465
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
6021209-4405 Issued in UT
Practice address
4505 S Wasatch Blvd Ste 260
Salt Lake City, UT 84124-4800
Phone
(385) 955-9579
NPI assigned
Feb 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 6021209-4405 UT Primary
Registered Nurse 163W00000X 60212093102 UT

Addresses

Primary practice location

4505 S Wasatch Blvd Ste 260
Salt Lake City, UT 84124-4800

Mailing address

4505 S Wasatch Blvd Ste 260
Salt Lake City, UT 84124-4800
Phone (385) 955-9579

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210930002741 UT Practitioner - Nurse Practitioner 5799182978 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
60212093102UTMDRegistered Nurse
6021209-4405UTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Psychological Services Inc CurrentSince Apr 12, 2023 Accepting new patients

Locations

1208 E 3300 S
Millcreek, UT 84106
Phone (801) 450-1128

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.

NPI Registry JSON

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1780278465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 S WASATCH BLVD STE 260",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841244800",
            "telephone_number": "385-955-9579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 S WASATCH BLVD STE 260",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841244800",
            "telephone_number": "385-955-9579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "TIFFANY",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "RN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-23",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "6021209-4405",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "60212093102",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.