Individual provider Active NPI

Shane Flannery Hurst, MS

  • Marriage & Family Therapist
  • Ogden, UT
National Provider Identifier
1821282419
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
6586446-3904 Issued in UT
Practice address
237 26TH St
Ogden, UT 84401-3105
Phone
(801) 625-3700
NPI assigned
Aug 28, 2007
Last updated
Aug 28, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 6586446-3904 UT Primary

Addresses

Primary practice location

237 26TH St
Ogden, UT 84401-3105

Mailing address

237 26TH St
Ogden, UT 84401-3105
Phone (801) 625-3700

Other identifiers 1

IdentifierTypeStateIssuer
876000308007MedicaidUT

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240410001459 UT Practitioner - Marriage and Family Therapist 5890133888 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6586446-3904UTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Weber Human Services CurrentSince Feb 28, 2024 Accepting new patients
The Help Clinic Marriage & Family Therapist Current Accepting new patients
Weber Human Services CurrentSince Feb 28, 2024 Accepting new patients

Locations

237 26th St
Ogden, UT 84401
Phone (801) 625-3605

962 Chambers St
Ste 11
South Ogden, UT 84403
Phone (801) 458-1356

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1821282419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 26TH ST",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844013105",
            "telephone_number": "801-625-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 26TH ST",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844013105",
            "telephone_number": "801-625-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURST",
        "first_name": "SHANE",
        "middle_name": "FLANNERY",
        "name_prefix": "Mr.",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "6586446-3904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "876000308007",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.