LIFE TREE PLLC (NPI# 1982135265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982135265 |
| Entity Type | Organization |
| Organization Name | LIFE TREE PLLC |
| Other Organization Name | LIFE TREE PSYCHIATRY |
| Practice Address |
251 W State Road 198 Ste 3 Salem UT 84653-5608 |
| Practice Telephone | 8015046665 |
| Practice Fax Number | 8015049073 |
| Mailing Telephone | 8015046665 |
| Mailing Fax Number | 8015046073 |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2019-10-21 |
| Authorized Official Name | DR. JOSH HOOTON (OWNER/PROVIDER) |
| Authorized Official Telephone | 8055046665 |
| Authorized Official Credential | DNP, FNP-C, PMHN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
6227164-4405 | UT | Ambulatory Health Care Facilities |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ANCC PMHNP BOARD CERTIFICATION | 2019033956 | 01 |
| Other Name | Type Code |
|---|---|
| Life Tree | Doing Business As Name - Organization |
| Life Tree Psychiatry | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 179 N 1200 E Ste 104, Lehi, UT 840432255 | 8015046665 | 8015046073 |
| Street Address |
251 W STATE ROAD 198 STE 3 |
| City | SALEM |
| State | UT |
| Zip Code | 84653-5608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306272471 | Josh Hooton | Nurse Practitioner | 251 W State Road 198 Ste 3, Salem, UT 84653-5608 | 2013-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487008603 | Douglas Robert Clark | Optometrist | 446 N State Road 198, Salem, UT 84653 | 2016-04-14 |
| 1811357791 | Melanie Pace | Dental Hygienist | 818 East 750 South, Salem, UT 84653 | 2016-03-04 |
| 1265773899 | Bill Clifford Marshall | Marriage & Family Therapist | 405 S Maple Dr, Woodland Hills, UT 84653 | 2013-03-06 |
| 1013159995 | Elder Assisted Living LLC | Assisted Living Facility | 1015 S 550 W, Salem, UT 84653 | 2009-03-24 |
| 1780884247 | David Kent Hansen | Dentist | 204 East 400 North, Suite A, Salem, UT 84653 | 2007-07-23 |
| 1154524965 | Justin Thomas Perry | Dentist | 40 South 200 West, Salem, UT 84653 | 2007-06-08 |
| 1013130947 | John E Braithwaite | Dentist | 40 S 200 W, Salem, UT 84653 | 2007-04-10 |
| 1104972827 | Salem City Corporation | Ambulance | 30 W 100 S, Salem, UT 84653 | 2007-01-26 |
| 1700989209 | James Bryan Bonny | Dentist | 245 W State Hwy 198, Suite 6, Salem, UT 84653 | 2006-09-07 |
| 1578574570 | Kids Who Count | Day Training, Developmentally Disabled Services | 345 N Sr 198, Salem, UT 84653 | 2006-08-11 |
| Find all providers in zip 84653 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366073421 | Aspire Telepsychiatry | Nurse Practitioner | 1910 24th St Ne, Salem, OR 97301-8150 | 2020-01-28 |
| 1962058362 | Kimberly Diane Nelson | Nurse Practitioner | 35 Congress St Ste 225, Salem, MA 01970-5529 | 2019-08-13 |
| 1861970972 | Norrine Mcnelley | Nurse Practitioner | 25 Beechwood Rd, Salem, NH 03079 | 2018-07-31 |
| 1235493495 | Sarah Frances Robbins | Nurse Practitioner | 1595 Roosevelt St Ne, Salem, OR 97301 | 2012-07-02 |
| 1700155538 | Vanessa Anne Underwood | Nurse Practitioner | 1595 Cottage St Ne, Salem, OR 97301-7123 | 2011-12-22 |
| 1134364524 | Sharon Vaden Karn | Nurse Practitioner | 870 Commercial St Se, Salem, OR 97302-4108 | 2008-12-12 |
| 1861605768 | Barbara S Miller | Nurse Practitioner | Odoc, 2605 State St, Salem, OR 97310-0001 | 2007-05-07 |
| 1538225818 | Aleyna Cecile Reed | Nurse Practitioner | 685 Cottage St Ne, Salem, OR 97301-2419 | 2006-12-29 |
| 1407915408 | James Ben Newman | Nurse Practitioner | 1235 Woodrow St Ne, Salem, OR 97303-3214 | 2006-12-06 |
| 1033285713 | Rita Herlong | Nurse Practitioner | 4035 12th Street Cutoff, Suit120, Salem, OR 97302-1764 | 2006-11-27 |
| Find all providers in SALEM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.