Individual provider Active NPI

Zacharia Isaia Roberts, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Payson, UT
National Provider Identifier
1881186385
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
8029277-4405 Issued in UT
Practice address
1000 E 100 N
Payson, UT 84651-1600
Phone
(801) 465-7041
Fax
(801) 465-7409
NPI assigned
May 31, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 8029277-4405 UT Primary

Addresses

Primary practice location

1000 E 100 N
Payson, UT 84651-1600

Mailing address

PO Box 742353
Atlanta, GA 30374-2353

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
I20200615001145 UT Practitioner - Nurse Practitioner 0648692947 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountainstar Behavioral Health LLCGroup PAC ID 1052558186, 13 clinicians

Practice addresses (Care Compare)

1000 E 100
Payson, UT 84651-1600
Phone (801) 465-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8029277-4405UTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Sep 1, 2021 Accepting new patients
Mountainstar Behavioral Health LLC CurrentSince Jul 1, 2020 Accepting new patients
Serenity TMS Centers LLC CurrentSince Apr 1, 2022 Accepting new patients
Ascent Mental Health PLLC Psychiatric/Mental Health PastSince Jun 12, 2022 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

2132 N Robins Dr
Ste 300
Layton, UT 84041
Phone (801) 781-5092

3300 N Triumph Blvd
Ste 500
Lehi, UT 84043
Phone (801) 821-2333

1000 E 100 N
Payson, UT 84651
Phone (801) 465-7000

6550 S Millrock Dr
Ste 250
Salt Lake City, UT 84121
Phone (801) 754-6032

9710 S 700 E
Ste 113
Sandy, UT 84070
Phone (801) 523-6376

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Interoperability endpoints

  • Direct secure messaging: zacharia.roberts@hca3.eclinicaldirectplus.com

Organizations & group practices 4

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": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1881186385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742353",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 100 N",
            "city": "PAYSON",
            "state": "UT",
            "postal_code": "846511600",
            "telephone_number": "801-465-7041",
            "fax_number": "801-465-7409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ZACHARIA",
        "middle_name": "ISAIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-31",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "8029277-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Payson, UT

Sources for this page

Verify at the official NPI Registry.