Tristyn Teel Wilkerson, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

230 S 500 E
Suite 100
Salt Lake City, UT 84102-2015

Phone

(801) 532-1484

Fax

(801) 532-1486

NPI assigned

Sep 6, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Tristyn Leigh Teel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 27, 2017 through Oct 27, 2027

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514505600000",
    "number": "1306127253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 S REDWOOD RD",
            "address_2": "#28-21",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840886607",
            "telephone_number": "206-909-3085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 S 500 E",
            "address_2": "SUITE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022015",
            "telephone_number": "801-532-1484",
            "fax_number": "801-532-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "TRISTYN",
        "middle_name": "TEEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-06",
        "last_updated": "2017-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRISTYN",
            "last_name": "TEEL",
            "middle_name": "LEIGH",
            "credential": "PSY.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kyle David Wilkens
• Donald Keith Wilkerson, M.D.
• Jaclynn Wilkerson
• Kammi Elaine Wilkerson
• Rachel Wilkerson
• Ryan Woodrow Wilkes, PSYD
• Gavin Lloyd Wilkey
• Amber Wilkins I
• Cariann Irene Wilkins
• Grace Wilkins

• Psychologist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2017; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.