DR. AUSTIN BLAIR IMUS (D.O.) – Neurology Physician, NPI 1417923251

DR. AUSTIN BLAIR IMUS (D.O.) is a healthcare provider. based in Bountiful, Utah. specializing in PSYCHIATRY. They hold the professional credentials D.O.. They hold a License No. 178981-1204 (UT). The NPI Number for DR. AUSTIN BLAIR IMUS (D.O.) is 1417923251

Main info

Male
39 Years Of Experience
Accepts Medicare Assignment
Name
DR. AUSTIN BLAIR IMUS (D.O.)
NPI
1417923251
Phone
(801) 299-3773
Address
630 MEDICAL DR
Enumeration Date
23 February 2006
Last Update Date
14 December 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1987 (39 years ago)
PAC ID
9830081314
Professional Enrollment ID
I20040329000755
Address ID
UT840105765Bo117XX3100300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

256 PSYCHIATRY in UT

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Provider Addresses for DR. AUSTIN BLAIR IMUS (D.O.)

  • 630, Medical Drive, Bountiful, Davis County, Utah, 84010, United States

    BOUNTIFUL, UT 840104908

    Phone: (801) 299-3773

    Mailing address matches the actual address.

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.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-03-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040329000755IPsychiatryUTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

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 84010)

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Reviews

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Frequently asked questions

How is DR. AUSTIN BLAIR IMUS (D.O.) identified in CMS data?
CMS-hosted NPPES data lists DR. AUSTIN BLAIR IMUS (D.O.) with NPI 1417923251.
Can I rely on DR. AUSTIN BLAIR IMUS (D.O.) being an active provider?
As of the registry snapshot, DR. AUSTIN BLAIR IMUS (D.O.) is marked active.
What taxonomy line describes DR. AUSTIN BLAIR IMUS (D.O.)?
For research purposes, treat DR. AUSTIN BLAIR IMUS (D.O.) as Neurology Physician in this dataset. Clinical services aligned with this taxonomy classification.
What area does DR. AUSTIN BLAIR IMUS (D.O.) serve?
DR. AUSTIN BLAIR IMUS (D.O.)'s listing highlights Bountiful, Utah; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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