Individual provider Active NPI

Daemon Alexander Kao'O Garso, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Ogden, UT
National Provider Identifier
1841769221
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
6354739-4405 Issued in UT
Practice address
237 26TH St
Ogden, UT 84401-3105
Phone
(801) 625-3700
NPI assigned
Nov 15, 2018
Last updated
Jun 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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 6354739-4405 UT Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 6354739-3102 UT

Addresses

Primary practice location

237 26TH St
Ogden, UT 84401-3105

Mailing address

237 26TH St
Ogden, UT 84401-3105

Other identifiers 3

IdentifierTypeStateIssuer
260022408OtherUTRAILROAD MEDICARE
8760003008007MedicaidUT
000055266OtherUTMEDICARE PIN

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
I20240820001363 UT Practitioner - Nurse Practitioner 2264970383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Utah School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weber Human ServicesGroup PAC ID 3274430244, 42 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6354739-3102UTMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Weber Human Services CurrentSince Jun 13, 2024 Accepting new patients
Weber Human Services CurrentSince Jun 13, 2024 Accepting new patients

Locations

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

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, 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": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1841769221",
    "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"
        },
        {
            "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": "GARSO",
        "first_name": "DAEMON",
        "middle_name": "ALEXANDER KAO'O",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-15",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "6354739-4405",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "UT",
            "license": "6354739-3102",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "260022408",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8760003008007",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "000055266",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.