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UNIVERSITY OF UTAH PEDIATRIC BEHAVIORAL HEALTH SERVICES
NPI 1467320671
Psychiatry & Neurology - Sports Medicine in Salt Lake City, UT

Active since October 28, 2025
590 S WAKARA WAY, SALT LAKE CITY, UT 84108(801) 587-7109 Get Directions Write a Review

NPPES record last updated: October 28, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About University Of Utah Pediatric Behavioral Health Services NPPES

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

UNIVERSITY OF UTAH PEDIATRIC BEHAVIORAL HEALTH SERVICES (NPI 1467320671), doing business as Pediatric Sports Psychiatry, is a healthcare organization registered as a sports medicine in Salt Lake City, Utah and active in the NPI registry since October 2025. The organization lists Jeannine Rushton, Director, as its authorized official.

NPPES Registry Identity

NPI1467320671
Entity TypeOrganization
Primary Taxonomy2084S0010X
Legal Business NameUNIVERSITY OF UTAH PEDIATRIC BEHAVIORAL HEALTH SERVICES
Location Address590 S WAKARA WAYSalt Lake City, UT 84108-1200
Mailing AddressPo Box 841450Los Angeles, CA 90084-1450
Phone(801) 587-7109
Organization SubpartNo
Authorized OfficialJeannine RushtonDirector · (801) 587-6463
Enumeration DateOctober 28, 2025
NPPES CertifiedOctober 28, 2025
✔ NPI 1467320671 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2084S0010X
Definition
A psychiatrist or neurologist who specializes in the diagnosis and treatment of sports related conditions and injuries.
590 S WAKARA WAY, Salt Lake City, UT 84108
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Other Names 1

Doing Business AsPediatric Sports Psychiatry

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

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

KAYLA L. GATES MD
Orthopaedic Surgery
590 S WAKARA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-5448
THOMAS HONG MD
Student in an Organized Health Care Education/Training Program
590 S WAKARA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-7109
ANDREW KOSTURIK
Physical Therapist
590 S WAKARA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-7109
LUIS B. FANDINO MD
Orthopaedic Surgery
590 S WAKARA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-5448
NAOMI RUTH LAIRD PA-C
Physician Assistant
590 S WAKARA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-7109
DENNIS N. JACKSON MD
Emergency Medicine
590 S WAKARA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 581-2121
TREVOR WILTZ DPT
Physical Therapist
590 S WAKARA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-7109
DR. JOSHUA KURT JOHNSON DPT
Physical Therapist
590 S WAKARA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-7109

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is University Of Utah Pediatric Behavioral Health Services's NPI number?

The NPI number for University Of Utah Pediatric Behavioral Health Services is 1467320671. It was assigned to this organization in the NPPES registry on October 28, 2025. The provider is doing business as Pediatric Sports Psychiatry.

Where is University Of Utah Pediatric Behavioral Health Services located?

University Of Utah Pediatric Behavioral Health Services is located at 590 S Wakara Way, Salt Lake City, UT 84108. The listed phone number is (801) 587-7109.

What is University Of Utah Pediatric Behavioral Health Services's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Sports Medicine, with taxonomy code 2084S0010X.

When was this NPI record last updated?

The NPPES record for University Of Utah Pediatric Behavioral Health Services was last updated on October 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.