| Mountain Mental Health | |
|
4516 S 700 E Ste 370 Salt Lake City UT 84107-8317 | |
| (801) 918-1786 | |
| (385) 200-0285 |
| Full Name | Mountain Mental Health |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 4516 S 700 E Ste 370, Salt Lake City, Utah |
| Authorized Official Name and Position | Shane Emeron Carter (PMHNP) |
| Authorized Official Contact | 8019181786 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Mental Health 4516 S 700 E Ste 370 Murray UT 84107-8317 Ph: (801) 918-1786 | Mountain Mental Health 4516 S 700 E Ste 370 Salt Lake City UT 84107-8317 Ph: (801) 918-1786 |
| NPI Number | 1588378442 |
|---|---|
| Provider Enumeration Date | 01/05/2023 |
| Last Update Date | 08/30/2023 |
| Certification Date | 08/30/2023 |
| Medicare PECOS PAC ID | 7416314760 |
|---|---|
| Medicare Enrollment ID | O20230601001817 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588378442 | NPI | - | NPPES |
| Provider Name | Spencer Lowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427539014 PECOS PAC ID: 9133468291 Enrollment ID: I20190307000679 |
| Provider Name | Shane Emeron Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245955822 PECOS PAC ID: 8325405673 Enrollment ID: I20230601001958 |
| Provider Name | Raymond Searles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902544299 PECOS PAC ID: 1254789266 Enrollment ID: I20231201001515 |
| Provider Name | Karen Risch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043948037 PECOS PAC ID: 5092150565 Enrollment ID: I20240224000376 |
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