| Whole Mind Llc | |
|
1064 S North County Blvd Ste 385 Pleasant Grove UT 84062-3427 | |
| (801) 477-7189 | |
| Not Available |
| Full Name | Whole Mind Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1064 S North County Blvd Ste 385, Pleasant Grove, Utah |
| Authorized Official Name and Position | Thomas Allen Rayner (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8014777189 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Whole Mind Llc 770 E Main St Lehi UT 84043-2293 Ph: (801) 477-7189 | Whole Mind Llc 1064 S North County Blvd Ste 385 Pleasant Grove UT 84062-3427 Ph: (801) 477-7189 |
| NPI Number | 1659084879 |
|---|---|
| Provider Enumeration Date | 01/03/2023 |
| Last Update Date | 01/03/2023 |
| Certification Date | 01/03/2023 |
| Medicare PECOS PAC ID | 6406228220 |
|---|---|
| Medicare Enrollment ID | O20230203002164 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659084879 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 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 A 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 |
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