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UTAH STATE HOSPITAL
NPI 1811978620
Psychiatric Hospital in Provo, UT

Active since November 09, 2005
1300 E CENTER ST, PROVO, UT 84606(801) 344-4400(801) 344-4225 Get Directions Write a Review

NPPES record last updated: October 9, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 9, 2024, Sep 19, 2024, Jun 11, 2020 and 2 more (5 updates tracked since 2019).

About Utah State Hospital NPPES

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

UTAH STATE HOSPITAL (NPI 1811978620) is a healthcare organization registered as a psychiatric hospital in Provo, Utah and active in the NPI registry since November 2005. The organization lists Dallas Earnshaw, Superintendent, as its authorized official.

NPPES Registry Identity

NPI1811978620
Entity TypeOrganization
Primary Taxonomy283Q00000X
Legal Business NameSTATE OF UTAH
Location Address1300 E CENTER STProvo, UT 84606-3554
Mailing AddressPo Box 270Provo, UT 84603-0270 · (801) 344-4400 · Fax (801) 344-4225
Phone(801) 344-4400
Fax(801) 344-4225
Organization SubpartNo
Authorized OfficialDallas EarnshawSuperintendent · (801) 344-4200
Enumeration DateNovember 9, 2005
Last NPPES UpdateOctober 9, 20245 updates tracked since enumeration
NPPES CertifiedOctober 9, 2024
✔ NPI 1811978620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatric HospitalHospitals
Taxonomy Code283Q00000X
Definition
An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings.
1300 E CENTER ST, Provo, UT 84606
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Other Names 1

Doing Business AsUtah State Hospital

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Utah State Hospital is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

84

Medicare enrollment records show 84 clinicians reassign Medicare billing to Utah State Hospital, which bills Medicare for the services they deliver. Of these, 58 practice at this address and 63 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 9

Clinical Social Worker27
Psychiatry14
Clinical Psychologist13
Nurse Practitioner13
Family Practice9
General Practice3
Podiatry3
Dentist1
1 other specialty1

Nearest to this location (20)

See all 84
Ted Barratt, PH.D.
Clinical Psychologist
NPI 1427184878
1300 E CENTER ST
Provo, UT 84606
(801) 344-4215
✔ PECOSSame address
Michael Bartlett
Clinical Social Worker
NPI 1447507801
1300 E CENTER ST
Provo, UT 84606
(801) 344-4400
✔ PECOS✔ Accepts MedicareSame address
John Bench, M.D.
Psychiatry
NPI 1114905965
1300 E CENTER ST
Provo, UT 84606
(801) 344-4400
✔ PECOS✔ Accepts MedicareSame address
Douglas Benson, PSY.D
Clinical Psychologist
NPI 1306080544
1300 E CENTER ST
Provo, UT 84606
(801) 344-4400
✔ PECOS✔ Accepts MedicareSame address
Michael Benson, MD
Psychiatry
NPI 1538797659
1300 E CENTER ST
Provo, UT 84606
(801) 344-4400
✔ PECOSSame address
Rachelle Bird, LCSW
Clinical Social Worker
NPI 1205488566
1300 E CENTER ST
Provo, UT 84606
(801) 344-4400
✔ PECOSSame address
Kelly Brose, LCSW
Clinical Social Worker
NPI 1962811224
1300 E CENTER ST
Provo, UT 84606
(801) 344-4400
✔ PECOS✔ Accepts MedicareSame address
William Camp, LCSW
Clinical Social Worker
NPI 1023679263
1300 E CENTER ST
Provo, UT 84606
(801) 344-4215
✔ PECOSSame address
Denise Goettsche, DO
General Practice
NPI 1740225218
1300 E CENTER ST
Provo, UT 84606
(801) 344-4400
✔ PECOS✔ Accepts MedicareSame address
Elmo Gruwell, M.D.
General Practice
NPI 1598972655
1300 E CENTER ST
Provo, UT 84606
(801) 344-4400
✔ PECOSSame address
Margaret Gustafson, PHD
Clinical Psychologist
NPI 1336463868
1300 E CENTER ST
Provo, UT 84606
(801) 344-4400
✔ PECOSSame address
David Hillam, MD
Family Practice
NPI 1275623878
1300 E CENTER ST
Provo, UT 84606
(801) 344-4400
✔ PECOS✔ Accepts MedicareSame address
Kevin Holmes, M.D.
Psychiatry
NPI 1306871322
1300 E CENTER ST
Provo, UT 84606
(801) 344-4400
✔ PECOSSame address
John Jackson, M.D.
General Practice
NPI 1548321862
1300 E CENTER ST
Provo, UT 84606
(801) 344-4400
✔ PECOSSame address
Michael Johnson, APRN
Nurse Practitioner
NPI 1801381553
1300 E CENTER ST
Provo, UT 84606
(801) 344-4400
✔ PECOSSame address
Edward Kelly, MD
Psychiatry
NPI 1013995471
1300 E CENTER ST
Provo, UT 84606
(801) 344-4400
✔ PECOS✔ Accepts MedicareSame address
Julia Knaphus, APRN
Nurse Practitioner
NPI 1811484470
1300 E CENTER ST
Provo, UT 84606
(801) 344-4400
✔ PECOS✔ Accepts MedicareSame address
Courtney Lodin
Clinical Psychologist
NPI 1528528833
1300 E CENTER ST
Provo, UT 84606
(801) 344-4215
✔ PECOS✔ Accepts MedicareSame address
Scott Walker, DO
Family Practice
NPI 1528321627
1300 E CENTER ST
Provo, UT 84606
(801) 344-4400
✔ PECOSSame address
Kay Whittaker, APRN
Nurse Practitioner
NPI 1497793707
1300 E CENTER ST
Provo, UT 84606
(801) 344-4400
✔ PECOS✔ Accepts MedicareSame address
See all 84 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 State Of Utah's NPI number?

The NPI number for State Of Utah is 1811978620. It was assigned to this organization in the NPPES registry on November 9, 2005. The provider is doing business as Utah State Hospital.

Where is State Of Utah located?

State Of Utah is located at 1300 E Center St, Provo, UT 84606. The listed phone number is (801) 344-4400.

What is State Of Utah's specialty?

The primary specialty registered for this NPI is Psychiatric Hospital with taxonomy code 283Q00000X.

Is State Of Utah enrolled in Medicare?

Yes. State Of Utah is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through State Of Utah?

According to the CMS Revalidation Reassignment List (October 2026 release), 84 clinicians in 9 Medicare specialties reassign their Medicare billing to State Of Utah. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (27), Psychiatry (14) and Clinical Psychologist (13). Of these, 58 practice at this address and 63 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does State Of Utah accept?

Health plans from Molina Healthcare list State Of Utah as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for State Of Utah was last updated on October 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.