Active NPI
Michael William Tragakis, PH.D.
- Clinical Psychologist
- Salt Lake City, UT
National Provider Identifier
1164510426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6272971-2501
- Practice address
- 500 Foothill Drive 116B
VA Salt Lake City Health Care System
Salt Lake City, UT 84148-0001 - Phone
- (801) 582-1565
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 6272971-2501 | UT | Primary |
Addresses
Primary practice location
500 Foothill Drive 116B
VA Salt Lake City Health Care System
Salt Lake City, UT 84148-0001
Mailing address
3176 S 900 E Apt 5
Salt Lake City, UT 84106-2157
Phone (801) 520-1050
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 |
|---|---|---|---|
| 6272971-2501 | UT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226880000000",
"number": "1164510426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3176 S 900 E APT 5",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841062157",
"telephone_number": "801-520-1050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 FOOTHILL DRIVE 116B",
"address_2": "VA SALT LAKE CITY HEALTH CARE SYSTEM",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841480001",
"telephone_number": "801-582-1565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAGAKIS",
"first_name": "MICHAEL",
"middle_name": "WILLIAM",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2008-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "UT",
"license": "6272971-2501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.