Individual provider Active NPI

Ruby Sue Nelson, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Payson, UT
National Provider Identifier
1962070615
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
202451-8900 Issued in UT
Practice address
95 S 100 E Ste 300
Payson, UT 84651-2253
Phone
(801) 832-9338
Fax
(801) 832-0246
NPI assigned
Jun 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 202451-3102 UT
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 202451-8900 UT Primary

Addresses

Primary practice location

95 S 100 E Ste 300
Payson, UT 84651-2253

Mailing address

95 E 100 S
Suite 300
Payson, UT 84651
Phone (801) 382-9338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220425001171 UT Practitioner - Nurse Practitioner 2769879600 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.69 of 100Reported as group
Quality
89.02
Promoting interoperability
85
Improvement activities
40
Cost
55.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202451-3102UTMDAdult Psychiatric/Mental Health Registered Nurse
202451-8900UTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Numinus Wellness Ut Inc CurrentSince Apr 15, 2022 Accepting new patients
Deborah a Christensen PHD & Associates, Inc CurrentSince Oct 1, 2022 Accepting new patients

Locations

248 E 13800 S
Ste 4
Draper, UT 84020
Phone (702) 483-5044

672 W 400 S
Ste 201
Springville, UT 84663
Phone (208) 680-8226

Interoperability endpoints

  • Direct secure messaging: ruby.nelson.1@24259.direct.athenahealth.com

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": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1962070615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 E 100 S",
            "address_2": "SUITE 300",
            "city": "PAYSON",
            "state": "UT",
            "postal_code": "84651",
            "telephone_number": "801-382-9338",
            "fax_number": "801-382-0246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 S 100 E STE 300",
            "city": "PAYSON",
            "state": "UT",
            "postal_code": "846512253",
            "telephone_number": "801-832-9338",
            "fax_number": "801-832-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "RUBY",
        "middle_name": "SUE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-17",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "UT",
            "license": "202451-3102",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "202451-8900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Payson, UT

Sources for this page

Verify at the official NPI Registry.