Ampelis Health at Mindful Medical

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

AMPELIS HEALTH AT MINDFUL MEDICAL

Practice address

1525 E 6000 S
South Ogden, UT 84405-7144

Phone

(801) 337-5854

NPI assigned

Jul 29, 2022

Last updated

Dec 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Justin Weeks

Title

Partner

Phone

(801) 391-6660

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 3

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.

• Marysa Chieko Anderson-Cardwell, MS, RDN, LD

  • Registered Dietitian
  • Salt Lake City, UT
  • NPI 1255846630
  NPD (past)
• Shane Emeron Carter, PMHNP, APRN

  • Psychiatry Physician
  • Murray, UT
  • NPI 1245955822
  NPD (past)
• Hannah Farnworth, LMFT

  • Marriage & Family Therapist
  • Draper, UT
  • NPI 1013808732
  NPD (past)

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734566400000",
    "number": "1942936091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10290 N NORTH COUNTY BLVD STE 102",
            "city": "HIGHLAND",
            "state": "UT",
            "postal_code": "840038973",
            "telephone_number": "435-776-5909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E 6000 S",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844057144",
            "telephone_number": "801-337-5854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMPELIS HEALTH AT MINDFUL MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-29",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A",
        "authorized_official_last_name": "WEEKS",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "801-391-6660"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ampelishealth.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "1525 E 6000 S",
            "city": "South Ogden",
            "state": "UT",
            "country_code": "US",
            "postal_code": "844057144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessika Allen, PT, DPT ATC/L, FAAOM
• O. Kent Allen, LMFT
• Scott Allen
• Eliza Alvey
• Kessia Amaya Camacho, RBT
• Derek Andersen, L.M.F.T.
• Aidrey Anderson, RBT
• Christopher K Anderson, MD
• Kayla Anderson, RBT
• Amy Carol Andrews, APRN

• Psychiatry Physician in South Ogden, UT
• Providers in South Ogden, UT by specialty
• Psychiatry Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.