Active NPI
Sandra Flodin, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Murray, UT
National Provider Identifier
1790661320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 6218966-4405
- Practice address
- 1935 E Vine St Ste 170
Murray, UT 84121-2197 - Phone
- (801) 639-9833
- Fax
- (801) 639-9833
- NPI assigned
- Aug 11, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 62188966-8900 | UT | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 6218966-4405 | UT | Primary |
Addresses
Primary practice location
1935 E Vine St Ste 170
Murray, UT 84121-2197
Mailing address
1935 E Vine St Ste 179
Murray, UT 84121-2192
Phone (801) 639-9833
Other practice location 1
9164 S Maison Dr
Sandy, UT 84093-2434
Phone (801) 597-2413
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, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1935 E Vine St
Suite 170
Murray, UT 84121-2197
Phone (201) 488-5161
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62188966-8900 | UT | MD | Psychiatric/Mental Health Nurse Practitioner |
| 6218966-4405 | UT | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SL-Center of Revitalizing Psychiatry LLC | Current | Accepting new patients |
Locations
1935 E Vine St
Ste 170
Murray, UT 84121
Phone (201) 488-5161
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.
-
- Psychiatry Physician
- Murray, UT
- NPI 1194691931
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788134400000",
"number": "1790661320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1935 E VINE ST STE 179",
"city": "MURRAY",
"state": "UT",
"postal_code": "841212192",
"telephone_number": "801-639-9833",
"fax_number": "801-639-9833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1935 E VINE ST STE 170",
"city": "MURRAY",
"state": "UT",
"postal_code": "841212197",
"telephone_number": "801-639-9833",
"fax_number": "801-639-9833"
}
],
"practiceLocations": [
{
"address_1": "9164 S Maison Dr",
"address_purpose": "LOCATION",
"city": "Sandy",
"state": "UT",
"postal_code": "840932434",
"country_code": "US",
"telephone_number": "801-597-2413",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FLODIN",
"first_name": "SANDRA",
"credential": "PMHNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-08-11",
"last_updated": "2026-08-31",
"certification_date": "2026-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "UT",
"license": "62188966-8900",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "UT",
"license": "6218966-4405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Murray, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.