NPIMap

Organization Active NPI

Mindqa

  • Psychiatry Physician
  • Salt Lake City, UT
National Provider Identifier
1871029934
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
190584-4405-20151209 Issued in UT
Legal business name
MINDQA
Practice address
1174 E Graystone Way
Ste 4
Salt Lake City, UT 84106-2673
Phone
(801) 502-4650
NPI assigned
May 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Authorized official

Name
Robin JacobsNPI 1922202282
Title
Owner
Phone
(801) 502-4650

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 190584-4405-20151209 UT Primary

Addresses

Primary practice location

1174 E Graystone Way
Ste 4
Salt Lake City, UT 84106-2673

Mailing address

1174 E Graystone Way
Ste 4
Salt Lake City, UT 84106-2673

National Provider Directory

National Provider Directory

Locations

1174 E Graystone Way
Ste 4
Slc, UT 84106
Phone (801) 502-4650

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1871029934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1174 E GRAYSTONE WAY",
            "address_2": "STE 4",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 E GRAYSTONE WAY",
            "address_2": "STE 4",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062673",
            "telephone_number": "801-502-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDQA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-502-4650"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "190584-4405-20151209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.