| Neurohealth | |
|
10437 S Temple Dr Ste 200 South Jordan UT 84095-8899 | |
| (385) 464-3151 | |
| Not Available |
| Full Name | Neurohealth |
|---|---|
| Speciality | Clinic/Center |
| Location | 10437 S Temple Dr Ste 200, South Jordan, Utah |
| Authorized Official Name and Position | Bryan Dean Scott (MANAGING MEMBER) |
| Authorized Official Contact | 3857779766 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurohealth 9500 S 500 W Ste 205 Sandy UT 84070-2574 Ph: (385) 777-9766 | Neurohealth 10437 S Temple Dr Ste 200 South Jordan UT 84095-8899 Ph: (385) 464-3151 |
| NPI Number | 1831891316 |
|---|---|
| Provider Enumeration Date | 03/20/2023 |
| Last Update Date | 04/12/2024 |
| Certification Date | 04/12/2024 |
| Medicare PECOS PAC ID | 8325401250 |
|---|---|
| Medicare Enrollment ID | O20230825000678 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831891316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Joel W Hanson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619076205 PECOS PAC ID: 8820998149 Enrollment ID: I20040112000512 |
| Provider Name | Jennifer Ann Karr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417272170 PECOS PAC ID: 4789956632 Enrollment ID: I20170828001694 |
| Provider Name | Thomas Rayner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194008979 PECOS PAC ID: 0941533574 Enrollment ID: I20220808003003 |
| Provider Name | Alex J Mageno |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538727284 PECOS PAC ID: 9032586722 Enrollment ID: I20230629003702 |
| Provider Name | Jessie Ann Ritchey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023715364 PECOS PAC ID: 7416487277 Enrollment ID: I20250207002839 |
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