Michael Charles Desjardins, MSN, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

377701-4405 Issued in UT

Practice address

668 E 12225 S Ste 203
Draper, UT 84020-8385

Phone

(801) 572-8255

Fax

(801) 572-8144

NPI assigned

Mar 1, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

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.

• Care One Partners LLC

  • Multi-Specialty Clinic/Center
  • Draper, UT
  • NPI 1932618873
  NPD (past)
• Valley Behavioral Health Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Valley City, UT
  • NPI 1932166980

  Psychiatry

  NPD (past)

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1801924766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1812",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840201812",
            "telephone_number": "801-518-9203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "668 E 12225 S STE 203",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208385",
            "telephone_number": "801-572-8255",
            "fax_number": "801-572-8144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5689 S Redwood Rd Unit 30",
            "address_purpose": "LOCATION",
            "city": "Taylorsville",
            "state": "UT",
            "postal_code": "841235499",
            "country_code": "US",
            "telephone_number": "801-268-1715",
            "fax_number": "801-268-1783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESJARDINS",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "MSN, APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "377701-4405",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "377701-4405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "3777014408",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Delman
• Ashlyn Nicole Demke
• Mandy Denison
• Kylee Denning
• Madison Shirley Densley, LCSW
• Alexus Desmarais
• Nikolas Dewinne, PT, DPT
• Diederich DMD, PLLC
• Nikolas Kenneth Diederich, DMD
• Christina Dietz, CMHC

• Psychiatric/Mental Health Nurse Practitioner in Draper, UT
• Providers in Draper, UT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.