PRISM Provider Account Administrator Lookup

If your provider/facility is not listed, or if the administrator is no longer with your organization, please complete the user access request form opens in a new tab and email it to providerenroll@utah.gov.

Otherwise, please complete the user access request form opens in a new tab in the link below and send it to your administrator.

NPI

Provider Name

Administrator Name

1639160708

180 MEDICAL INC

Brakebill, Amanda

1366439507

3M Medical Solutions

Bingham, Rebecca

1033558697

4 Healing Center

Taylor, Christina

1033862719

Abel, Jordan

Abel, Jordan

1073137915

Abner, Hannah

Maki, Kimberly

1053821728

ABS UT PC

Coffey, Darla

Abundant Solutions LLC

Croxford, Nathan

Abundant Solutions LLC

Drollinger, Lance

1013482819

Active Home Health

Benson, Jackie

1497062681

Adachi, Iki

Naranjo, Maria

1922005347

ADAMS, MICHAEL

Francee, Francee

1538333265

ADVANCE MEDICAL SRVCS INC.

Anderson, Natalie

1245259282

ADVANCED DIABETES SUPPLY

Dailey, Patricia

1053357905

ADVANCED RESPIRATORY INC

Mouchet, Julie

1437627080

Advanced Spine and Pain PLLC

Antczak, Kelsey

1669780250

AFI HOSPICE LLC

Vining, Jeff

1457357881

Ahee, Jason

Crabtree, Sheli

1457357881

Ahee, Jason

GRIM, AMY

1346330966

AKERLEY III, WALLACE

Fuentes, Seth

1245414705

Allen Chiropractic Care, LC

Allen, Kevin

1851463087

AllianceRX Walgreens Pharmacy #15443

Morgan, Amey

1942650148

ALPINE MEADOW REHABILITATION AND NURSING

Tatum, Debra

1588235345

Altitude Pediatrics

Whitehead, Bradlie

1497805733

AMERIPATH TUCSON INC

Murdock, Angelina

1831800994

Anderson, Amy

Anderson, Amy

1598291486

Anderson, Bentley

MUMFORD, ELSA

1265073274

Anderson, Cole

Filby, Jennifer

1235741042

Anderson, Kristi

Bennett, Barbara

1619213212

ANOVORX GROUP LLC

Bellehumeur, Cathy

1891857272

APPLE TREE ASSISTED LIVING

Stoker, Elayne

1255659389

Arbelo Cruz, Norman

Barlow, Shenika

1962832071

Ardon Health

Magee, Muriel

1033782933

Arreola, Dayana

Birch, Ashly

1982606992

ASCEND CLINICAL, LLC

Manoukian, Leslie

1093399479

Ascend Healthcare Inc

Leslie, Joshua

1447296249

ASHLEY REGIONAL MED CNTR

Myers, Terri

1184778607

Aspen Ridge Home Health and Hospice

Wilson, Zachary

1861869091

Aspen Senior Care

Staples, Gary

1376548271

ASSOC REG and UNIV PATH LAB

Wilkerson, Stacey

1861842874

Aste, Whitney

Webster, Johanna

1922365436

Austin, Colby

Pohlman, Helen

1285627455

AZARCON JR, JOSE

Comeau, Kathleen

1841656691

Baker, Leanne

Flores, Leslie

1184814014

BAKOTIC PATHOLOGY SERVICES

Nguyen, Tiffany

1437113339

BALBIERZ, JANET

Balbierz, Carolyn

1376522573

BALLIF, MARK

Akrouche, Sarah

1831404136

Balwan, Akshu

KIRSLING, DONNA

1629148465

Banks, Steven

Sevy, Alisha

1275566200

BANNER ESTRELLA MED CNTR

Willis, Shaylee

1770697351

BARLOW, SHIRLEY

Felix, Meghan

1346536646

BARNETT, CHRISTOPHER

Barnett, Christopher

1194463133

Barney, Derek

Barney, Derek

1699239988

Barney, Meredith

Barney, Meredith

1245556661

Barrick-Groskopf, Lindsey

Hirth, Frances

1841633468

BARTON, KATHERINE

Miller, Christine

1841766201

Beatty, Taylor

Macias, Christine

1841766201

Beatty, Taylor

Pfatenhauer, Ashley

1174979108

BEAVER VALLEY HOSPITAL

Gale, Mindy

1760401525

Beebe, Jesse

Peterson, Kristen

1215302245

Beechtree Diagnostics LLP

LaFountain, Jennifer

1437780673

Beecon Recovery INC

Pool, Tony

Beehive Home of Layton

Dunkley, Noelle

Beehive Homes of Magna

Ibarra, Kimberly

1316356439

Beehive Homes of Washington County #5

Horne, Shauna

1275123143

Behavior Supports and Solutions LLC

Robles, Richard

BEL AIRE SENIOR LIVING

Freeze, John

1376255125

Bemis, Haley

Taylor, Camille

1346568565

BENEDETTI, NANCY

Anderson, Carla

1730681842

Benns, Catherine

Stone, Heidi

1225750417

Benyo, Brooklynn

Larson, Camille

1457719924

Bergeron, Penelope

Bergeron, Penelope

1598236457

Bergeson, Dane

Ortiz, Maricela

1699268581

Berquist, John

Powell, Melanie

1396107595

Berrett, Brian

Edwards, Kellie

1396107595

Berrett, Brian

Essex, Jennifer

1275912040

BIG SMILES UTAH PC

Amendt, Laura

1598314437

BillionToOne Laboratory

Waskiewicz, Mary

1295710960

BINGHAM, RONALD

Bingham, Ronald

1609818616

BISHOP, JON

Thomas, Lindsay

1851016380

Black, Angela

Dow, Mary

1356729859

Black, Elizabeth

Patterson, Jamie

1104120708

Blais, Adam

Blais, Adam

1508512757

Blakey, Melissa

Blakey, Melissa

1629620125

Boone, Stephen

Flanders, Khymm

1174539142

BOUNTIFUL FAMILY HEALTHCARE

Williams, Lacie

1841927175

Boynton, Kyla

Garcia, Samantha

1407187362

BRAUER, JACK

Miller, Jaime

1043635097

BRAVO, JOSHUA

Pace, Whitney

1750859583

Bridge Dialysis

Laurent, Christie

1295270601

Brightwork Villa Park Place LLC

Julian, Chris

1972172260

Bringhurst, Jackie

Ogden, Amanda

1750783783

Brown, Amy

Dumelow, Charann

1164627725

Brown, Colin

Whittington, Kimberly

1437816089

Brown, Jayci

Brown, Jayci

1437816089

Brown, Jayci

Harding, Christy

1093708166

Brown, Todd

Wehrli, Carlie

1528006103

BRYAN MEDICAL CENTER

Karr, Wendy

1710162227

BUCHANAN, THOMAS

Myers, Randall

1235557257

Buell, Eric

Cannon, Bonnie

1679082952

Bulloch, Micah

Bartlett, Gretchen

1669065470

Burg Children's Dentistry & Orthodontics - Vine Street

Bergmann, Lauren

1366118424

Butler, Scott

Kerness, Monica

1285663021

CACHE VALLEY PHARMACY

Cowley, Phillip

1316460850

Calm Clinic

Walker, Alicia

1295743763

Cannon, David

Kunde, Becca

1144984873

CAnvi Behavioral Health

Batts, Krista

1144984873

CAnvi Behavioral Health

McCarthy, Hailey

1881991701

CANYONLANDS CARE CENTER

Oxner, Becky

CARRINGTON COURT

Davis, Tery

1174569990

CARTER, RANDY

Ledbetter, Hannah

1689104812

Carter, Reed

White, Charmaine

1558628313

Carter, Sabrina

Apolinar, Angelica

1093895286

CASTILLO, WILLIAM

Ltd, William

1801464292

Castle, Bronwynne

Castle, Bronwynne

1972026227

Castleview Cardiology

Myers, Randall

1417064205

CASTLEVIEW HOSPITAL LLC

Powell, Hayley

1689084196

Caverly, Erin

Madril, Leslie

1104978790

CENTRAL VALLEY HOME HEALTH

Bryan, Janna

1770060980

Centro de Salud

Cruz, Maria

1912311192

chan, kamun

Prasad, Savita

1326407578

CHANCELLOR GARDENS AT CLEARFIELD

Munoz, Denise

1376521773

Chess, David

Chess, David

1801344726

Children's Service Society of Utah

Beckstead, Kassadi

1801344726

Children's Service Society of Utah

Gallardo, Encarni

1396079471

CHISHOLM, RICHARD

Chisholm, Richard

1316118284

CHISHOLM, WAYNE

Chisholm, Wayne

1073627295

CHRISTENSEN, BRETT

Kolu, Melaine

1992198618

Christensen, Kay

Christensen, Kay

1891898045

CHRYSALIS UTAH DDMR

Carroll, Bryce

1811979214

CLAYTON, DANIEL

Packer, Kris

1336149426

COCHLEAR AMERICAS

Devlin, Rebecca

1326306481

Cohen, Ariel

Hultberg, Eric

1104395821

COLOR COUNTRY PHYSICAL THERAPY LLC

Applegate, Chellese

1124023981

Colorado Infectious Disease Associates LLP

Malisch, Uma

1306831250

Colorado West Otolaryngol

Lenz, Jeannine

1336508571

COMFORCARE NORTHERN UT NC

Bushman, Raquel

Community Care Transitions Program- Waivers

Pavelka, Emily

1639127079

Community Nursing Services

Long, Melissa

1477809051

Connect America.com LLC

Parchesky, Sara

1437493533

Conversio Health

Henderson, Debbie

1285287821

CORMEUM LAB SERVICES LLC

Silliman, James

1114371580

Corner Canyon Counseling

Cortez, Julian

1821163726

COTTAGE GLEN ASSISTED LIV

Pulsipher, Alex

Country Home Assisted Living

Simmons, Conner

1104037563

COUNTRY PINES PHASE 2

Bach, Cheryl

1831686823

Covington Senior Living LLC

Anderson, Riley

1700143906

Cox, Daniel

Larsen, Lori

1740941541

Cracroft, Stephen

White, Lindsey

1649353715

CRAWFORD, GARY

Shively, Linsey

1225119837

Crawford, Ira

Crawford, Ira

1205404290

Creek Dental Group- Trolley Place

Eddings, Jessica

1104077817

CROWLEY, JAMES

Flinton, Lori

1104077817

CROWLEY, JAMES

Levanger, Charisse

1427076405

DACHMAN, WILLIAM

Resendez, Monica

1710975420

Dalere, Mente

Kilgore, Latisha

1639412125

DARAGON, ELLISANDRE

Hage, Kathleen

Darwin Transportation LLC

Spitzer, Kevin

1861621864

DAVIES, JARROD

Halling, Kennadee

1649364670

DAVIES, KENDELL

Davies, Kendell

1740406842

DAVILA, L

Davila, L.John

DAVIS COUNTY AGING SRVC AW

Mahan, Shawna

1265191316

Day, Gordon

Day, Gordon

1144955691

Day, Julie

Jensen, Devin

1114937984

DEL CARMEN, VILLA

Bermudez, Monique

1922308618

Dentistry For Children

Rooklidge, Erik

1114287612

DEPOLA, MICHAEL

Doxey, Sarah

1689635799

DERMATOLOGY CENTER OF SALT LAKE.

Loveless, Melissa

1821477951

Dickinson, Regina

Morehead, Mindy

1184398836

Disera, Anna

Grant, Susan

1760972178

Dorsett, Bret

Chengappa, Katherine

1992005938

DR JEFFREY TIPTON OD PC

Tipton, Jeffrey

1841681640

Draper, Chelise

Stone, Heidi

1104390111

Duke Mobile Medical

Ausmus, Dawn

1972960201

Durrani, Ayefa

Shumway, Lindsey

EAQUINTA, EVELYN

Riche, Debra

1952355935

Eastern Idaho Regional Med Center

Tuckett, Cody

1730688987

Edgepark Medical Supplies - Pharmacy

Schlissberg, Rob

1609858729

EdgeparkMedicalSupplies

Alvarez, Anthony

1821606476

Elder, Ryan

Smith, Sherian

1427211325

ELDREDGE, DANIEL

Eldredge, Daniel

1821030909

Electromed Inc.

Korum, Kathy

1831679588

Elevate Home Health LLC

Gillman, Jennifer

1326503053

Elevation Behavioral Science Services

Merritt, Danielle

1932848678

Elite Carpel Tunnel LLC

Taylor, Susan

1023376340

Elliot, Shari

Bowers, Shylah

1821761867

Embrace Counseling

Green, Shantaye

1659954501

Empowered Me Counseling Centers

Draughan, Heather

1205377256

English, Brittany

Diviney, Chuck

1659945343

Enoch Community Healthcare

Merrell, Stuart

1396348181

Ensign, Kelly

Quaife, August

Enter

Andres, Jacquelyn

1659599611

ERICKSON, JEFF

Phillips, Allison

1023754561

Escalante at Coventry

Anderson, Marsha

1598428906

Escalante at Draper

Ellison, Suzanne

1568407310

Eskenazi Health

Lang, Rebecca

1487034369

ESPLIN, TREY

Esplin, Trey

1093374738

Estall, Julianna

Estall, Julianna

1104255215

ETHOS LABORATORIES1

Holloway, Jessica

1417629007

Evans, Elisa

Grow, Tj

1811942964

EVANS, WILLIAM

Price, Valerie

1780823500

Exact Care Pharmacy LLC

Fenwick, Sarah

1760956221

Eye Pros

George, Laurel

1760126825

Falks, Viveca

Vergara, Gabriela

1508040221

Family Surgical Suite

Smith, Michelle

1003820234

FENTON, PAUL

Garcia, Tammy

1396971271

FERGUSON, JARED

Rabuck, Megan

1356792634

Fit Prosthetics LLC

Reynolds, Alex

1114154622

Fit-Well Prosthetic And Orthotic Center

Hunsaker, Chris

1588937403

FLD LLC

Martin, Joshua

1679128599

Flourish Therapy, Inc.

Tew, Samuel

1952015273

Ford, Aubrey

Olsen, Jennifer

1265034086

FRANDSEN, HEIDI

Decker, Jennifer

1922028554

FRANKLIN, JOACHIM

Enrollment, Provider

1710280177

FRASER, ASHLEI

FRASER, ASHLEI

1801563051

Frazier, Alysha

Ward, Meg

1417280678

FRESH MARKET PHARMACY #2307

Roberts, Jessica

1265146336

Fullmer, Jennie

Lynn, Julie

1174915425

Gables of Brigham City

Willits, Dave

1679902936

GABLES OF N LOGAN ASSIST LIVING

Willits, David

1770187163

Gadzoom Health LLC

Owen, Jackson

1003023177

Galloway, Elizabeth

Torralba, Belle

1720560915

Gamble, Adrienne

Mortensen, Amber

1811245970

Gandhi, Viral

Alpough, Sheneaqua

1225449887

Ganti, Arun

Vanderpool, Dana

1487294211

Garcia Valdez, April

Garcia, April

1588223622

Gardiner, Rebecca

Powell, Crystal

1528780772

Gardner, Grace

Ruud, Ryan

1598861999

GARY F HOLLAND MD PC

Krumbah, Sara

1144705583

Gashler, Brian

Stinson, Kenyon

1780251835

Gates, Melissa

Alfaro, Rachel

1275098998

Gateway Physical Therapy and Sports Rehab

Malan, Melissa

1386275055

Gatrell, Rebecca

Barton, Rebecca

1215078696

Gebauer, Lothar

Hargett, Kairee

1588942502

Genoa Healthcare LLC

Dixon, Carol

1225490444

Gensure, Rebekah

Ledbetter, Hannah

1508145632

GEORGE, MICHAEL

Coley, Natalie

1619336252

Gerry, Sherrie

Gerry, Sherrie

1851595854

Giangiacomo, Faye

Bowden, Amber

1003218702

Gilbert, Kathryn

Larraondo, Maria

1528555257

Glauser, Karen

Garcia, Tammy

Golden Fences

DeGregoria, Juanita

1477098945

Gonzales-Torres, Maria

Viertel, Taylor

1396180386

GONZALEZ, Abigail

Coffman, Lora

1811902505

GOPINATH, ARASU

Davis, Jennifer

1255597043

GRACEY, NATHAN

Gracey, Nathan

1396967535

Grand Preschool

Sweeney, Judy

1306829056

GRANDY, LAWRENCE

Jackman, Linzi

1306829056

GRANDY, LAWRENCE

Thompson, Taylor

1295103935

GUBLER, MATTHEW

Schwartz, Dayna

1033210067

GUBLER, TROY

Olsen, Caleen

1407926272

GUNN, JOSHUA

Lathim, Sari

1952463036

GUNNISON VALLEY HOSPITAL

Murray, Brian

1952463036

GUNNISON VALLEY HOSPITAL

Williams, Skylah

1952463036

GUNNISON VALLEY HOSPITAL

Williams, Skylah

1952790230

HANCOCK, CHARRISSE

Chengappa, Katherine

1396007316

Hansen, Kellen

Tanner, Marquel

1144782558

Harline Andelin, Kate

Andelin, Kate

1700447612

Harper, Jason

Harper, Jason

1538542030

Harper, Madison

Benson, Carrie

1548745979

Harris, Mitchell

Tice, Rachel

1578626727

HARTLE, AARON

Hartle, Aaron

1144751611

Hartman, Hanna

John, Laura

1508125295

Hartman, Neal

Tobine, Tony

1194365742

HAWKINS, RILEY

Davis, Alison

1295820199

HAWKINS, ROBERT

Martinez, Erika

1821663675

Hawks, Daxton

Olson, Kristen

1477740249

HBHM, Inc

Moren, Kathleen

1316055205

HEBER VALLEY HOSPITAL

Bagshaw, Shawna

1396802617

Heber Valley Physical Therapy Inc

Clyde, Willis

1881268514

Hedges, Natalia

Hallis, Michelle

1508109489

Henrie, Nathan

Enoah, Sandra

Heritage Gardens of Springville Utah LLC

Vom Dorp, Rebecca

1376096966

Herriman Pediatric Dentistry

Shigley, Alisha

1790274652

Hervias, Matthew

Schulz, Angela

1508044314

Hinich, Erin

Cannon, Bonnie

1457611725

Hintzsche, Gabriel

Vanderpool, Dana

1730706458

Hoffmann, Audrey

Thompson, Kandee

1215248612

HOFMANN ARTHRITIS INST

Tanner, Linsey

1912118225

Hoglund, Stephanie

Thurgood, Raunde

1770124893

Holladay Psychological Services

Harris, Emily

1740761360

Holliday, Dashelle

Holliday, Dashelle

1891455895

Home Clinix

Holmgren, Danny

Home Helpers of St.George

Coon, Benjamin

Home Helpers of St.George

Seniors, Paradigm

1033199922

Homecare Medical Equipment

Rotech, Rotech

Hometown Personal Care Services, LLC

Runolfson, Amie

1508464371

Homewatch CareGivers of Scipio

Mckee, Michelle

1508464371

Homewatch CareGivers of Scipio

Whatcott, Kevin

1548450281

Horizon HOSPICE SPECIALISTS

Woolley, Scott

1215969787

HOSP OF PROV SIERRA CAMPUS

Barnett, Mendy

1558978684

Howard, Ashlee

Swearingen, Regan

1265842579

Huey, Elyse

Winn, Greg

1396298048

Huffaker, Paul

Collis, Ashley

1861158537

Hull, Jessica

Fisher, Tiffany

1144387622

HULSE, BENJAMIN

Hulse, Benjamin

1316686058

Hunsaker, Jenna

Piciullo, Teressa

1184335697

Hutchinson, Kacey

Hutchinson, Kacey

1265784656

IN FOCUS OPTICAL

Soderborg, Lisa

1326294844

Inglish, Daniel

Neal, Deborah

1215125463

INNOVIS HEALTH LLC

Klonowski, Crystal

1881856706

INTEGRITY HOSPICE LLC

Babin, Ethan

1366560484

INTERMOUNTAIN MEDICAL MANAGEMENT JAHAN IMANI MD

Imani, Jahangir

1437184421

Ishimine, Paul

Hultberg, Eric

1083635692

IVY LANE PEDIATRICS LLC

Hess, Jarika

1083635692

IVY LANE PEDIATRICS LLC

Rodriguez, Nannette

1174840870

JACKETTA, DANIELLE

Fisher, Suzanne

1174840870

JACKETTA, DANIELLE

Jacketta, Danielle

1457950529

Jacobson, Justin

Rosas, Camila

1396918462

JACOBS-PETERSON, LUANN

Cates, Laura

1912418898

Jacquez, Nathan

Jacquez, Nathan

1043657471

JB Healthcare LLC

Accordino, Deidre

1598351041

JBR Surgical Associates LLC

Bertola, Britney

1780302158

Jefferies, Garrett

Rowley, Jamie

1376116764

Jenna Shirley Counseling

Moffat, Hollie

1568929347

Jeppesen, Crystal

Sutton, Patricia

1477584993

JOHN F KENNEDY MEMORIAL HOSPITAL

Larson, Christopher

1629001474

JOHNSON, JODIE

Revas, Natalee

JOHNSON, PRISCILLA

Giffard, Mary

1437779410

Johnson, Sandra

Garner, Andre

1699039644

Jolley, Elliott

Jolley, Elliott

1225652290

Jones, Angela

Hill, Claudia

1972089571

Jones, Brian

McPhie, Jennifer

1629493242

Jones, David

Ford, Leslie

1255862827

Jones, Eric

Mattinson, Amanda

1740857804

Jones, Kashley

Gagon, Gina

1487963278

Jordan Landing Dental Care PC

Erickson, Andrew

1770509754

JORDAN RIDGE FAMILY MEDICINE

Sanchez, Maureen

1316974108

JORGENSEN, JAMES

Monroe, Stacie

1871649467

Joseph W Jensen DO PC

Karasek, Stephanie

1619960663

JQ MEDICAL SUPPLY INC

Thurman, Tricia

1750020855

JWalker Intensive Outpatient

Bowen, Mallory

1104484377

Kale, Vijay

Kale, Vijay

1710010343

Katwal, Arabindra

Garcia, Tammy

1235657214

Kendrick, Jillian

Lovelace, Valeria

1407321722

KENWORTHY, TRENT

Mata, Enrique

1467504746

KHAN, HASSAN

Galinas, Missy

1750634507

KIDDE, JASON

Knight, Connie

1750634507

KIDDE, JASON

Velardo, Jessica

1851611206

KILLIAN, JOSHUA

Loescher, Becky

1922380153

KIMBALL, PAIGE

Everley, Austin

1164884441

King, Christine

Bakker, Briele

1164884441

King, Christine

Vieira, Danielle

1134849300

Kippen, Hollie

Stubbs, James

1134849300

Kippen, Hollie

Yeip, Tana

1134849300

Kippen, Hollie

Yeip, Tana

1649780701

Korchyk, Ashley

Miggains, Taylor

1962175109

Krukow, Philip

John, Laura

1649377540

KRULL, ANGELA

Merrill, Marci

1285357814

Kwiatkowski, Kaitlin

Fehrman, Jessie

1285357814

Kwiatkowski, Kaitlin

Fritzsche, Kristal

1285357814

Kwiatkowski, Kaitlin

Rein, Samantha

1134188394

L CRAIG LARSEN DPM PC

Lofthouse, Whitney

1730179714

Lakewood Ranch medical Center

Madril, Leslie

1477178697

Lambert, Colton

Arguello, Marina

1265446751

Langford, Jefferson

Ryan, Jessica

1932551801

Larson, Jeremy

Larson, Jeremy

Laurel Groves Assisted Living

Eddington, Heather

1457450777

Leavitt, David

Bracken, Holli

1053755769

Lee, Muriel

Lee, Muriel

1396778015

Lemos-Filho, Luciano

Khounphonh, Vicki

1801873534

LIBRE, KENNETH

Libre, Kenneth

Lifeline Systems Company

Croci, Dahci

1871260497

Lighthouse Youth & Family Therapy

Crane, Charles

1255845665

Lind, Meridith

Knapp, Karla

1619605714

Livingston, Rachel

Livingston, Rachel

1013339373

LLOYD, KAYDON

Purcell, Kathryn

1457564650

LLOYD, WENDY

Lloyd, Wendy

1538547641

LOMOND PEAK NURSING AND REHABILITATION

Anderson, Wendy

1538547641

LOMOND PEAK NURSING AND REHABILITATION

Calder, JoAnne

1952833220

Lucas, Fabiola

Godoy, Cristopher

1831296508

Luckart, JULIE

Shutt, Jodi

1558737452

LUND, ALEXANDRIA

Lund, Alexandria

1912072620

LUND, TRACE

Markham, Kevin

1659885317

Lundquist, MaryNell

Sawyer, Amy

1043811045

Mabon, Nathan

Chavez, Laura

1205154978

Macfarlane, Lindsey

Macfarlane, Lindsey

1689635914

MADSEN, EDWARD

MADSEN, EDWARD

1336672633

Madsen, Sara

Tucker, Gennie

1114110079

MALAN, VERNON

Chase, Darin

1992330732

Manco, Justin

Manco, Justin

1629098108

MANOV, LUDMIL

Durfee, Denise

1801119599

Mansfield, Sonya

Fonte, Katie

1821559519

Marett, John

Bird, Jill

1174281018

Marula, LLC

Davis, Vicki

1598906455

Mason Health Mason Clinic

Vanderpool, Dana

1184044190

Maxwell, Kevin

Wood, Stacey

1164041570

McAdams, Kassondra

McAdams, Kassondra

1295017630

McAffee, Coy

Mcaffee, Coy

1093898157

MCBEE, WILLIAM

Heyes, Danielle

1093898157

MCBEE, WILLIAM

Shively, Linsey

1922423532

McCormick, Michael

Garcia, Selena

1194915561

MCDONALD, RYAN

Chappuis, Jennie

1366157166

McKinney, Caleb

Villalobos Vargas, Jocelyn

1902905714

MCMULLIN, KARL

Delucchi, Becky

1245657501

MEADOWBROOK REHAB NURS

Lee, Suzanne

1053801340

Mears Health Mart Pharmacy

Mears, Jonathon

1720306566

Med Fusion, LLC

Rando, Kathy

1073102901

Medical Accident Center

Brown, Sara

1639777568

Megan Komatsu Inc

Komatsu, Megan

1326488651

Mehta, Disha

Goss, Charlene

1639195472

Meier and Marsh Professional Therapies

Vidal, Anna

1023094992

MELLOR, ROBERT

Dutton, Catie

1518273119

Melton, Joshua

Waldrop, Angela

1437882503

Merrill, Alyssa

Merrill, Alyssa

1205177722

Mervyn Sharp Bennion Central Utah Veterans Home

Ahlstrom, Christina

1457318917

MESA VISTA

Root, Karen

1679829477

Metcalf, Jamison

Gubler, Mitchell

1083937593

METHODIST HOSPITAL

Myers, Courtney

1023745346

Middleton, Benjamin

Castagna, Valerie

1023480225

MILLCREEK REHABILITATION AND NURSING

Wheeler, Kamarie

1497933162

MILLENNIUM HEALTH LLC

Jansen, Vanessa

1871912386

Miller, Elan

Liberti, Lindsey

1720798648

Misner, Kimberly

Misner, Kimberly

1205573540

Mitchell, Megan

Manley, Amanda

1134680093

Mitchell, Shasta

Jensen, Erika

MOBILITY TRANSPORTATION

McDonald, Jackie

1588393821

Mojave Health, LLC

Romero, Lauren

1730194523

MOLIS, GREGORY

Molis, Greg

1679122261

Monogram Biosciences, Inc

Moore, Alayna

1134831647

Montague, Nickolas

Yocum, Amy

1336854595

Montes, Jennifer

Montes, Jennifer

1528083771

Montrose Memorial Hospital

Beaver, Megan

1528085016

Morrill, David

Morrill, David

1497118897

Morris, Erin

Hernandez, Jennifer

1861983074

Morrison, Nicole

Probert, Brittany

1386744183

MOUNTAIN VIEW HLTH SRVCS

Boden, Evangeline

1972500445

MOUNTAIN WEST INC

Lisk, Lauara

1750655692

MRB ACQUISITION CORP

Brown, Elizabeth

1538345251

MULTICARE VALLEY HOSPITAL

Akimseu, Nikki

1699282426

Murdock, Brett

Murdock, Brett

1942396643

MYERS, JOSEPH

Bracero, Stephanie

1942396643

MYERS, JOSEPH

Elmer, Darci

1902377146

NAKAMURA, AIMEE

Searle, Mona

1710149299

National Seating and Mobility Inc

Nepp, Brenda

1710149299

National Seating and Mobility Inc

Weiss, Connie

1356307581

NEBRASKA MEDICAL CENTER

Adcock, Stacie

1417004227

NEIBAUR, BEN

Neibaur, Ben

1770851602

Neibaur, Jacob

Drapic, Jess

1750473948

NEPHROLOGY ASSOCIATES GRP

Ekre, Amber

1588767891

NEWMAN, CHRISTY

Olson, Leslie

1467100461

Newman, Jody

Palencia, Claudia

1205227709

Newman, Tyler

Hancey, Elisha

1013082270

Newton, Steve

Burnam, Soon

1144364662

NIITSUMA LIVING CENTER INC.

Niitsuma, Danielle

1336302876

Nim, Jennifer

Yergensen, Aj

1649457219

NORRIS, LISA

Stapleton, Randee

1366077273

NPH Anesthesia of Utah LLC

Bradley, Laura

1750759809

OAK RIDGE ASSISTED LIVING

Young, Tyler

1508436890

OASIS Ascent

LeSueur, Suzy

1730265919

Obstetrix of the Mountain States, Pediatrix Specialty Care of Utah, Surgical Specialty Care of Utah

Hernandez, Jennifer

1336273390

OLSON, MARK

Olson, Mark

1508810508

OLYMPUS FAMILY MEDICINE

Thurgood, Annie

1922181650

Optum Frontier Therapies, LLC

Curran, Mary

1528502788

Orn industries LLC

Stevens, Michelle

1669797742

ORR, ROCHELLE

Garcia, Tammy

1881250470

Orton, Amy

Stone, Heidi

1750026456

Orton, Dean

Albrecht, Tyler

1720718521

Overstreet, Kamryn

Kener, Madalyn

1417974098

OVESON, MARK

Nelson, Von

1194033407

Ovian, Deepa

Keeney, Sara

1750691077

PACK, LELAND

Tanner, Samantha

1518959535

Packer, Kraig

Hess, Bree

1184118390

PARKWAY HEALTH CENTER

Porter, Whittney

1184118390

Parkway Health Center

Porter, Whittney

1689916116

Parsell, Elizabeth

Gray, Kari

1437445509

PATTY, DANIEL

Harden, Jennifer

1841869930

Pearce, Tate

Griffiths, Ricquelle

1366711087

Pediatric Smiles and Braces

Shepherd, Adam

1205290053

Pediatric Surgeons

Hutchinson, Richard

1083220578

Perry, Amy

Perry, Amy

1528041662

PERSONAL PERFORMANCE MED

Hunsaker, Carolyn

1972078251

Peterson, Kyle

Peterson, Kyle

1467464925

PharMerica.

Edwards, Lisa

1811614811

Phoenix Mental Health Services

Roberts, Alisa

1679956445

PINE TOP MEDICAL PC

Murdock, Holly

1801874771

PIONEERS MEDICAL CENTER

Coulter, Danette

1801874771

PIONEERS MEDICAL CENTER

Quint, Maria

1801874771

PIONEERS MEDICAL CENTER

Walton, Hannah

1235136235

PLEASANT GROVE AMBULANCE

Peterson, Tyler

1346271251

POPLAR HEALTHCARE PLLC

Cain, Julie

1124677547

Precision Psychological Services PLLC

Bowen, Megan

1730466590

PRECISION TOXICOLOGY

Livesay, Amanda

1487191573

Premier Lab Solutions

Oltrogge, Candice

1588969539

PRIMARY CARE PEDIATRICS

Brenchley, Lindsay

1639769953

Prime Labs LLC

Richardson, Marcus

1548367063

PRISM MEDICAL PROD

Groce, Candice

1053363119

PROVIDENCE ALASKA MEDICAL CENTER

KORKIS, JILL

1417038951

PsychologicalAssessmentandTreatmentSpecialists

Gentry, Steve

1215167531

Purkey, Neha

Truong, Hanh

1619161007

Pursifull, Nathan

Langell, Patricia

1548835911

Quadrant Laboratories LLC

Fiore, Caitlin

1750001277

Quiroz, Andrea

Wood, April

1295403913

Ramer, Maureen

Golesh, Jeremiah

1568431575

RAPPLEYE, ALAN

Millet, Debbie

1598982233

RASMUSSEN, ROCHELLE

Rasmussen, Rochelle

1437870540

Red Rock Clinical Services

Henthorn, Angela

1669746525

RED ROCK HLTHCARE HOSPICE

Johnson, Lee

1669746525

RED ROCK HLTHCARE HOSPICE

Van Leeuwen, Lynsey

1396018545

Red Rock Medical Supply

Liskey, Michelle

1508962176

REDDY, CHAKRAVARTHY

Lee, Cheryl

1114016706

REDWOOD PHARMACY UUHN

Howell, Kellee

1639264427

REDWOOD VISION CENTER

Brown, Paula

1063405074

REGENTS OF THE UNIV OF CA

Brown, Jessyka

1891451712

Rising Ridge Recovery

Young, Susan

1164137170

River Hollow Mental Health PLLC

Mortensen, Amber

1043936446

Rivera, Sharon

Chee, Kaylan

1750993341

Roberts, Allyson

Utley, Tristan

1851884043

Roberts, Diana

Maldonado, Cynthia

1336753755

Roberts, Laurel

Little, Heather

1144281122

Robertson, Glenn

Pauly, Lindsay

1376218222

Robinson, Amy

Terry, Karley

1053456095

Robinson, Gary

Robinson, Gary

1700302809

Robinson, Vicki

Dalanhese, Rick

1700302809

Robinson, Vicki

Larson, Taylor

1306818190

ROCCO, JEFFREY

Gordon, Tina

1346332970

ROCK SPRINGS IV CENTER

Wright, Melinda

1659725588

ROMERO, MLINDSEY

Lontine, Karry

1285803361

ROY VISION CENTER INC

Rencher, Stacy

1174288062

Rural Dietitians

Reidhead, Alyssa

1295208742

Ruske, Christian

Ruske, Christian

1548549066

Sagis PLLC

Castro, Jane

1417946021

SAINT JOSEPH HOSPITAL

Streeper, Amy

1235260795

SALT LAKE VALLEY HLTH DEPT

Fuchs, Tennielle

1235260795

SALT LAKE VALLEY HLTH DEPT

Smithee, Maureen

1932166980

SALT LAKE VALLEY MENTAL HLTH

Smith, Melinda

1932166980

SALT LAKE VALLEY MENTAL HLTH

Villalobos Vargas, Jocelyn

1043267727

Samaritan Hospital

Roberts, Derrick

1700168721

Sanchez, Brandon

Gilbert, Tawnya

1710207642

Sanchez, Chad

Gonzalez, Victor

1851529333

SANTAQUIN PHARMACY

Marchant, Kevin

1811521339

Schultz, Heidi

Marchant, Katie

1770091241

Schultz, Scott

Johnson, Antoinette

SEASONS OF SANTAQUIN

Wells, Mikala

1619583580

Serrato, Galia

Martinez, Jessica

1235527698

Sexton, Kayla

Pessetto, Nicolette

1487996427

Shackelford, Tyler

Alpough, Sheneaqua

1205449402

Sharifan, Jasmine

Agnivanshi, Kamlesh

1730529421

SHEPHERD, MITCHELL

Taylor, Kathy

1720154883

SHIELDS, KRISTEN

Pietsch, Celia

1063979557

Shumway, Kelsey

Shumway, Kelsey

1659574804

Siebertz, Brandi

Squire, Bridgett

1639101116

Sierra Vista Hospital Regional Medical Center

Larson, Christopher

1730141334

SIMMONS, ROBERT

Arnett, Cathy

1245261783

Sluss, James

AHERN, RAMONA

1639348899

SMITH, STACY

Smith, Stacy

1881755817

SMITH, TRAYSA

Fulmer, Cyndee

1174064125

SMITHS PHARMACY 271

Bone, Victoria

1356716534

Solara Medical Supplies LLC

Hynes, Jaimee

1104137108

SOLI, KATIE

Paxman, Wendy

1689242307

Sondrup, Clifford

Spurgeon, Paul

1407942725

SORENSEN, JAMES

Sevy, Alisha

1528286226

Sorensen, Jerold

Sorensen, Jerold

1215407598

Sorenson, Anabelle

Bixler, Robert

1770951030

South Ogden Home

Lucero, Shannon

1770573586

South Texas Health System

Mann, Michelle

1285688515

SOUTHWEST BEHAVIORAL HLTH CNTR

Sawyer, Art

1801342738

Sparenborg, Morgan

Bunkall, Heather

1801342738

Sparenborg, Morgan

Harrison, Dianna

1356369938

SPENCER, STEVEN

Mitchell, Christy

1306573993

Spero ABA

Sanders, Sarah

1033503420

SPRING CREEK SURGICAL CENTER

Tingley, Ben

1093713091

ST FRANCIS COMM HOSP

McKinnon, Selena

1356084107

St. George Red Rocks Oral Surgery

Mack, Jared

1003162058

STACY R. SMITH MD.PC

Smith, Stacy

1962599290

STANDARD OPTICAL 3

Greuber, Chelsea

1578290573

Stein, Kevin

Fairbanks, Melissa

1043461940

Stellini-Turner, Stephanie

Kenneth, Gwen

1922235019

STEPHENSON, PHILLIP

Bean, Julia

1760800353

Stephenson, Ryan

Prusse, Tim

1992428536

Stepping Stones Family Counseling

Kennedy, John

1992090104

STOKES, ALYSHA

Robinette, Trudi

1922676915

Stone, Amy

Braner, Krista

1922676915

Stone, Amy

Lorensen, Cassie

1962961748

Stonebridge Home Care South

Bishop, Jenna

1962961748

Stonebridge Home Care South

Van Leeuwen, Lynsey

1500000009

STONEHENGE OF CEDAR CITYUT INC

Fiduccia, Liz

1699744367

STORHEIM, JOHN

Bliss, Summer

1639538788

Stroshine, Scott

Galt, Casey

1134502875

SUN TREE HOME HEALTH LLC

Pinero, Ginger

1134502875

SUN TREE HOME HEALTH LLC

Sutton, Amanda

1477281699

Sustainable Healthcare

Mooney, Jennifer

1396902482

Sutton Counseling Services

Fisiipeau, Katy

1922738947

Swallow, John

Swan, Matthew

1649732322

Swanson, Kevin

Archuleta, Jennifer

1053691238

Swift, Travis

Hiner, Lorraine

1184914772

SYMBII HOME HEALTH

Bird, Shonda

1275531139

SYRACUSE CITY CORPORATION

Bennett, Michelle

1124446216

TANGARO, JOEL

Childress, Camber

1396785341

Tatton, James

Young, DeAnn

1699146233

TAYLOR, DYLAN

Anderson, Vanessa

1407294614

Teem Family Clinic

Teem, Lori

1407438039

Tellica Imaging, LLC West Valley

Beechy, Jake

7000000092

TEST IV CONTRACT PROVIDERS

Steve, Scuba

The Grandkids LLC

Richardson, Caleb

1669738662

THE HEALTH SPOT INC

Waldron, Amber

The INN Between

Litz, Allison

1295113793

THE WISDOM TEETH GUYS

Dunn, Carrie

1174678320

Tholstrom, Tad

Wollard, Amy

1528412756

Thomas, Megan

Thomas, Megan

1952657934

TIBBITTS FAMILY PHARMACY

Tibbitts, Brett

1679929707

Tkach, Christopher

Johnston, Michelle

1588620819

Tobias, Joseph

Bausch, Chelsea

1033578141

TOLLSTRUP, SARA

Abdulla, Kourtney

1033578141

TOLLSTRUP, SARA

Ravipati, Ram

1033320791

TOMCO, ABRAHAM

Cox, Vicki

1144290479

TOPHAM, ROBERT

Topham, Robyn

1750099420

Torres, Makinzi

Kalm, Jennifer

1790317477

Trek Counseling PLCC

Arteaga, Kaylem

1265793657

Tsai, Amy

AHERN, RAMONA

1912194499

Turning Point Centers

Draper, Kelley

1508216581

Twu, Jesse

Abdulla, Kourtney

1508216581

Twu, Jesse

Wessel, Brad

1306883954

UNIVERSITY OF UTAH HOME INFUSION PHARMACY

Hansen, Brittney

1306883954

UNIVERSITY OF UTAH HOME INFUSION PHARMACY

Slade, Jamie

1578652160

UNIVERSITY OF UTAH SOUTH JORDAN PHARMACY

Howell, Kellee

1154773158

Urban Indian Center of Salt Lake

Castro, Letitia

1790425965

Uriona, Sharon

Swearingen, Regan

1376206755

UT OMS Specialty Dental Services PLLC

Heyes, Danielle

1689788762

Utah Pain and Rehab inc

Marchese, Shery

Utah Payee Services, LLC

Haslam, Michael

1154745693

UTAH PRIDE CENTER

Fry, Jessica

1689674301

UTAH STATE DEVELOP CENTER

Peterson, Jennifer

1649204553

UTAH VALLEY ER PHYS INC

Hage, Kathleen

1588863377

VALLEY OBSTETRICS AND GYNECOLOGY - American Fork

Morrison, Dana

1780182683

ValleyFit Clinic LLC

Villalobos Vargas, Jocelyn

1184144594

Vawdrey, Heidi

Nye, Wendy

1396943494

VERNON, YOHANNA

Brenchley, Lindsay

1770058265

Victory EMS

Laurent, Christie

1144650664

VISKER, JAMES

Visker, James

1194048918

VRX PHARMACY AT CITY CREEK

Dawson, Cameron

1922013960

WALGREENS PHARMACY #07052

Hess, Sally

1134588296

Walke, MICHELLE

Tapia, Erika

1134588296

Walke, MICHELLE

Western, Kelci

1841669082

Walker, Jodi

Walker, Jodi

1164036265

Wall, Raquel

Wall, Raquel

1164036265

Wall, Raquel

Wall, Raquel

1841217031

Walmart Pharmacy 10-3208

Henry, Richard

1528504800

Walters, Kevin

George, Angela

1326054412

Ward, Mark

Ross, Jamie

1679645139

Wasatch Imaging LLC

DeJulis, Terri

1972652311

WEBER HUMAN SERVICES AW

Iizuka, Nobu

1043243140

WEBER HUMAN SERVICES1

Calderon, Rosie

1013431584

WEBER, ZACHARY

Esnaola, Sara

1871621920

West Ridge

Champion, Zacc

1851324826

Westwood Physical Therapy Clinic

Hobusch, Frederick

1679820401

WHALEY-PRYOR, GIGI

Whaley-Pryor, Gigi

1023770179

Whatcott, Webb

Whatcott, Webb

1780069401

Whetten, Ivan

Johnson, Kelly

1538760889

Whiting, Matthew

Treatment, Alpha

1275007338

Wickersham, Michelle

Fuller, Randi

1942736087

Wigant, Jeanne

Black, Dianna

1356095558

Wilcox, Elizabeth

Griffiths, Tary

1770515934

WILDE, LARRY

Wilde, Larry

1073738076

wilkins, scott

Wilkins, Scott

1124367032

Williams, Kristin

Stallings, Saskia

1447718887

Williams, Nathalia

Wessel, Brad

1184097537

Williford, Melissa

Malone, Hannah

1336740695

Wimmer, Jodi

Guymon, Heather

1568974434

Wisdom Teeth Guys of Utah

Dunn, Carrie

1144975053

Wood, Jennifer

Wood, Jennifer

1003539651

Woodruff, Korrie

Fehrman, Jessie

1760825582

WRIGHT, ELIZABETH

Brinkerhoff, Amberly

1376733196

WRIGHT, KRISTEN

Steele, Arlana

1407415714

Yates, Bryce

Maxfield, Meriah

1467831263

Yeaman, Candice

Yeaman, Candice

1528485570

Zand, Sam

Hamm, Nakia

When completing the user access request form, you will need to specify which profile(s) you want for PRISM. Use the following table to determine which profile(s) you need.

Function

Profile

Area

Modify provider information, submit new enrollment, and disenrollment requests.

EXT Provider Credentialing Specialist

Provider Enrollment

Add or modify EDI information including submission method, contact, and trading partner. User can submit changes to DOH.

EXT Provider EDI Team

Provider Enrollment

View only access, cannot make modifications.

EXT Provider View Only

Provider Enrollment

View, upload and submit files to DOH.

EXT Provider Upload Files

Provider Enrollment

View HIPAA Response/Acknowledgements and upload HIPAA files. View TPN Information.

EXT EDI Analyst

Provider Enrollment

Submit claims

Claims Submitter - Provider

Claims

Inquire on claims, including pharmacy claims.

Claims Inqury - Provider

Claims

Submit claims, inquire on claims including pharmacy claims, and adjust/void claims.

Claims Processor - Provider

Claims

Create a PA or modify a PA that is not in a final status.

EXT PA Provider Access

Prior Authorization

Create a PA or modify a PA that is not in a final status. Create an Admission Record for Nursing Facility and Hospice.

EXT Admission/PA Provider Access

Prior Authorization

Member eligibility inquiry

EXT Member Provider Access

Member Eligibility

Create TPL lead, View member TPL information

EXT TPL Provider Access

TPL

Access EHR incentive information link and the eMIPP system to update/submit eligibility, appeals, audits and payment information.

Provider EHR Incentive Specialist

EHR

Complete new provider enrollment or validate converted provider data. Approve any new users for the Provider’s domain. Management for the organization, including uploading scanned user agreements, assigning user profiles and managing/terminating user access. Profile does not have access to EHR Incentives.

EXT Provider Account Administrator

Security