Individual provider Active NPI

Raymond Searles, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Murray, UT
National Provider Identifier
1902544299
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
7000451-4405 Issued in UT
Practice address
4516 S 700 E Ste 370
Murray, UT 84107-8317
Phone
(385) 449-9990
NPI assigned
May 25, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 7000451-8900 UT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 7000451-4405 UT Primary

Addresses

Primary practice location

4516 S 700 E Ste 370
Murray, UT 84107-8317

Mailing address

1304 W Dupont Ave
Salt Lake City, UT 84116-3647
Phone (801) 864-4274

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
I20231201001515 UT Practitioner - Nurse Practitioner 1254789266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Mental Health LLCGroup PAC ID 7416314760, 4 clinicians

Practice addresses (Care Compare)

4516 S 700
Suite 370
Salt Lake City, UT 84107-8317
Phone (801) 918-1786

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7000451-8900UTMDNurse Practitioner
7000451-4405UTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Mental Health LLC Psychiatric/Mental Health CurrentSince Nov 1, 2023 Accepting new patients
Clinical Consultants Family Clinic PastSince Aug 28, 2022 Accepting new patients

Locations

4516 S 700 E
Ste 370
Salt Lake City, UT 84107
Phone (385) 449-9990

7601 S Redwood Rd
Bldg E
West Jordan, UT 84084
Phone (801) 233-8670

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1902544299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 W DUPONT AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841163647",
            "telephone_number": "801-864-4274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4516 S 700 E STE 370",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841078317",
            "telephone_number": "385-449-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEARLES",
        "first_name": "RAYMOND",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-25",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "7000451-8900",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "7000451-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.