Individual provider Active NPI

Bret Hafen

  • Psychiatric/Mental Health Nurse Practitioner
  • Layton, UT
National Provider Identifier
1982060828
Registry record updated Aug 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5485608-4405 Issued in UT
Practice address
934 S Main St
Layton, UT 84041-7135
Phone
(801) 773-7060
NPI assigned
Jan 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5485608-8900 UT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5485608-4405 UT Primary

Addresses

Primary practice location

934 S Main St
Layton, UT 84041-7135

Mailing address

934 S Main St
Layton, UT 84041-7135
Phone (801) 773-7060

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
I20171009001458 UT Practitioner - Nurse Practitioner 1557636180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Utah School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Davis Behavioral Health IncGroup PAC ID 7416861919, 61 clinicians

Practice addresses (Care Compare)

934 S Main St
Layton, UT 84041-7135
Phone (801) 773-7060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Davis Behavioral Health Inc CurrentSince Jul 25, 2019 Accepting new patients
Davis Behavioral Health Inc Psychiatric/Mental Health CurrentSince Sep 1, 2017 Accepting new patients

Locations

934 S Main St
Layton, UT 84041
Phone (801) 336-1845

2250 N Robins Dr
Layton, UT 84041
Phone (801) 779-3001

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": "1452124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501804800000",
    "number": "1982060828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "934 S MAIN ST",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840417135",
            "telephone_number": "801-773-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "934 S MAIN ST",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840417135",
            "telephone_number": "801-773-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFEN",
        "first_name": "BRET",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-07",
        "last_updated": "2017-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "5485608-8900",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "5485608-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.