Kayleen M Fuller, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

200419-2501 Issued in UT

Practice address

8706 S 700 E Ste 103
Sandy, UT 84070-1808

Phone

(801) 652-2720

Fax

(801) 606-7738

NPI assigned

Jun 4, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Calm Mind, Inc.

  • Clinical Psychologist
  • Sandy, UT
  • NPI 1215360425

  Clinical, UT

  Medicare reassignment NPD Authorized official
• Competance Inc

  • Community/Behavioral Health Agency
  • Sandy, UT
  • NPI 1053604157
  NPD (past) Authorized official
• Wasatch Spinal Care PLLC

  • Chiropractor
  • Sandy, UT
  • NPI 1154766749
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1073552402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8706 S 700 E STE 103",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840701808",
            "telephone_number": "801-652-2720",
            "fax_number": "801-606-7738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8706 S 700 E STE 103",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840701808",
            "telephone_number": "801-652-2720",
            "fax_number": "801-606-7738"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2666 S 2000 E Ste 101",
            "address_purpose": "LOCATION",
            "city": "Slc",
            "state": "UT",
            "postal_code": "841091721",
            "country_code": "US",
            "telephone_number": "801-652-2720",
            "fax_number": "801-606-7738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "KAYLEEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "200419-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Freedom Healthcare, LLC
• Ethan Thomas Freeman
• Christian Fritze
• Froerer Counseling Services
• Jared Daniel Froerer, LPC
• Larry D Fullmer
• Steven Fultz
• Joseph Clark Fyans, M.D.
• Sarah Gadsby, LCSW
• Katherin Bernice Galieti, LPC

• All providers in Sandy, UT
• Clinical Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.