TYSON JAMES BRINKERHOFF PMHNP-BC - NPI 1104624774 - Registered Nurse in Tooele, UT

Q: What is Tyson Brinkerhoff's NPI number?

The NPI number for Tyson Brinkerhoff is 1104624774. It was assigned to this individual provider in the NPPES registry on March 7, 2025.

Q: What is Tyson Brinkerhoff's specialty?

The primary specialty registered for this NPI is Registered Nurse with taxonomy code 163W00000X.

Q: When was this NPI record last updated?

The NPPES record for Tyson Brinkerhoff was last updated on March 20, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Tyson James Brinkerhoff Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYSON JAMES BRINKERHOFF PMHNP-BC (NPI 1104624774) is an individual registered nurse in Tooele, Utah, licensed in Utah (10826752-3102) and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1104624774

Entity TypeIndividualMale

Primary Taxonomy163W00000X

Provider Legal NameTYSON JAMES BRINKERHOFFCredential: PMHNP-BC

Location Address1244 N MAIN ST STE 101Tooele, UT 84074-9839

Mailing Address1244 N Main St Ste 101Tooele, UT 84074-9839 · (435) 244-3143 · Fax (435) 359-5221

Phone(435) 260-5521

Fax(435) 359-5221

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateMarch 7, 2025

Last NPPES UpdateMarch 20, 20266 updates tracked since enumeration

NPPES CertifiedMarch 20, 2026

✔ NPI 1104624774 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRegistered NurseNursing Service Providers

Taxonomy Code163W00000X

License✔ Licensed in UT · 10826752-3102

Definition

(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.

Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X · License 10826752-4405 (UT)

1244 N MAIN ST STE 101, Tooele, UT 84074

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health, University of Utah Health Plans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Enrolled in Medicare (PECOS)

Tyson James Brinkerhoff Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5799261087

PECOS Enrollment IDI20260107001056

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PAULETTE NIELSON

Registered Nurse (Infusion Therapy)