Active NPI
David M Erekson, PHD
- Clinical Psychologist
- Provo, UT
National Provider Identifier
1114679073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 9137996-2501
- Practice address
- 1500 WSC
Provo, UT 84602-7924 - Phone
- (801) 796-2361
- NPI assigned
- Jan 21, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 9137996-2501 | UT | Primary |
Addresses
Primary practice location
1500 WSC
Provo, UT 84602-7924
Mailing address
1500 WSC
Provo, UT 84602-7924
Phone (801) 796-2361
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | daveyerekson@protonmail.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9137996-2501 | UT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642723200000",
"number": "1114679073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 WSC",
"city": "PROVO",
"state": "UT",
"postal_code": "846027924",
"telephone_number": "801-796-2361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 WSC",
"city": "PROVO",
"state": "UT",
"postal_code": "846027924",
"telephone_number": "801-796-2361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EREKSON",
"first_name": "DAVID",
"middle_name": "M",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-01-21",
"last_updated": "2022-01-21",
"certification_date": "2022-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "UT",
"license": "9137996-2501",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "daveyerekson@protonmail.com",
"affiliation": "N",
"address_1": "1500 Wsc",
"city": "Provo",
"state": "UT",
"country_code": "US",
"postal_code": "846027924",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.