CLINT W PETERSON (APRN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1063642510

Psychiatric/Mental Health Nurse Practitioner

CLINT W PETERSON (APRN) is a healthcare provider. based in Provo, Utah. specializing in Psychiatric/Mental Health Nurse Practitioner. They hold the professional credentials APRN. They hold a License No. 5938005-3102 (UT). The NPI Number for CLINT W PETERSON (APRN) is 1063642510

Main info

Male

14 Years Of Experience

Accepts Medicare Assignment

Name

CLINT W PETERSON (APRN)

NPI

1063642510

Phone

(801) 234-9543

Address

1266 OAK HILL CIR

Enumeration Date

17 July 2009

Last Update Date

17 April 2025

Doctor Profile

Medical School Name

OTHER

Secondary Phone

8013734760

Graduation Year

2012 (14 years ago)

PAC ID

9537384920

Group Practice PAC ID

2567367915

Professional Enrollment ID

I20140626001651

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience65

Completeness75

Years active:16State licenses:2Digital endpointsOther names

Provider Addresses for CLINT W PETERSON (APRN)

1266 OAK HILL CIR
PROVO, UT 846043726
Phone: (801) 234-9543
Type: Mailing
5600 HERITAGE SCHOOL DR
PROVO, UT 846047701
Phone: (801) 226-4659
Fax: (801) 705-5362
Type: Location
750, North Freedom Boulevard, North Park, Provo, Utah County, Utah, 84601, United States
PROVO, UT 846011677
Phone: (801) 373-9656
Type: Location
400 West, Payson, Utah County, Utah, 84651, United States
PAYSON, UT 846512702
Phone: (801) 234-9543
Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84604)

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Provider's Procedures

CLINT W PETERSON (APRN) performs procedures in Psychiatric/Mental Health Nurse Practitioner. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
NURSE PRACTITIONER	UT	90792	Psychiatric diagnostic evaluation with medical services	37	37

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 2567367915View full group profile

Name	Specialty	State
DALLAS BEAN	-	UT
MRS. KAREN DEE AMSDEN (LCSW)	-	UT
MARLENE SISSON (LCSW)	Clinical Social Worker	UT
DR. MITCHELL WAYNE HARRIS (PHD)	-	UT
MARY JEAN RIDGES (LCSW)	Clinical Social Worker	UT
CONNIE LYNN WINN	-	UT
BRET JOHN LINTON (BS, MSW, LCSW)	-	UT
TRAVIS J HUNTER (APRN-INTERN)	Nurse Practitioner	UT
MS. LISA JANE OLSEN (APRN)	-	UT
KEVIN HARMON	Clinical Social Worker	UT

Reviews

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Frequently asked questions

Does CLINT W PETERSON (APRN) share an NPI with anyone else?

NPI numbers are unique to each provider or organization — CLINT W PETERSON (APRN) uses 1063642510.

Is CLINT W PETERSON (APRN) still practicing?

CLINT W PETERSON (APRN) is currently listed as active in the public NPI registry.

What healthcare role does CLINT W PETERSON (APRN) hold?

Scheduling teams often label CLINT W PETERSON (APRN) under Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.

What address line appears for CLINT W PETERSON (APRN)?

CLINT W PETERSON (APRN)'s geographic hint is Provo, Utah in our summary view.

Is specialty guaranteed by NPI alone?

Taxonomy selections describe intent; scope of practice still follows state law.