Clay Jorgenson, PYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

11959255-2501 Issued in UT

Practice address

595 N Locust Ave
Lindon, UT 84042-1316

Phone

(801) 717-5131

NPI assigned

Dec 8, 2020

Sex

Male

Sole proprietor

Yes

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 CA

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1184220766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 N LOCUST AVE",
            "city": "LINDON",
            "state": "UT",
            "postal_code": "840421316",
            "telephone_number": "801-717-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 N LOCUST AVE",
            "city": "LINDON",
            "state": "UT",
            "postal_code": "840421316",
            "telephone_number": "801-717-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSON",
        "first_name": "CLAY",
        "credential": "PYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-08",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "11959255-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Raymond Jensen, PH.D.
• Kenneth Hal Johnson, PHARMD
• Marion Hess Johnson, CSW
• Jennifer Rachael Jones, ACMHC
• Josef Jones
• JTC Advanced Practice
• Chloe Clarice Karren
• Michael S. Kennedy, MD
• Aubrey Kidd
• Kimball Crofts MD LLC

• Clinical Psychologist in Lindon, UT
• Providers in Lindon, UT by specialty
• Clinical Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; 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.