NPIMap

Organization Active NPI

Optum Behavioral Care of Ohio, Inc

Doing business as Sundance Behavioral Resources of Utah

  • Counseling Psychologist
  • Murray, UT
National Provider Identifier
1942076633
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
OPTUM BEHAVIORAL CARE OF OHIO, INC
Doing business as
Sundance Behavioral Resources of Utah
Practice address
310 E 4500 S Ste 600
Murray, UT 84107-4246
Phone
(801) 264-9522
Fax
(801) 265-9604
NPI assigned
Dec 4, 2023
Last updated
May 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Authorized official

Name
Kerry Biscornet
Title
Secretary
Phone
(603) 854-2929

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X NU Primary

Addresses

Primary practice location

310 E 4500 S Ste 600
Murray, UT 84107-4246

Mailing address

11000 Optum Cir
Eden Prairie, MN 55344-2503
Phone (603) 854-2929

Other names 1

  • Sundance Behavioral Resources of Utah Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240723004739 UT Part B Supplier - Clinic/Group Practice 7719325083 Receives reassigned benefits from 18 practitioners
1 other NPI on this enrollment
Practice locations: Murray, UT; Provo, UT

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Optum Behavioral Care of Ohio Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1942076633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11000 OPTUM CIR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553442503",
            "telephone_number": "603-854-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E 4500 S STE 600",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841074246",
            "telephone_number": "801-264-9522",
            "fax_number": "801-265-9604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM BEHAVIORAL CARE OF OHIO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-04",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "BISCORNET",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "603-854-2929"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sundance Behavioral Resources of Utah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.