Individual provider Active NPI

Melissa Lynne Devries, PH.D.

  • Psychologist
  • Salt Lake City, UT
National Provider Identifier
1306136353
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
7449978-2501 Issued in UT
Practice address
324 E 10TH Ave
Suite 200
Salt Lake City, UT 84103-2853
Phone
(801) 408-7500
NPI assigned
Apr 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 7449978-2501 UT Primary

Addresses

Primary practice location

324 E 10TH Ave
Suite 200
Salt Lake City, UT 84103-2853

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 408-7500

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140621000031 UT Practitioner - Clinical Psychologist 5890919443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

12473 S Minuteman Dr
Draper, UT 84020-7870
Phone (801) 495-7970

2655 W 9000
West Jordan, UT 84088-8542
Phone (801) 568-9933

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Jan 6, 2017 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jan 6, 2017 Accepting new patients
Ihc Health Services Inc Current Accepting new patients

Locations

12473 S Minuteman Dr
Draper, UT 84020
Phone (801) 495-7900

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

324 Tenth Ave
Ste 200
Salt Lake City, UT 84103
Phone (801) 355-9951

2655 W 9000 S
West Jordan, UT 84088
Phone (801) 256-6343

5373 W Lake Park Blvd
West Valley City, UT 84120
Phone (801) 902-7940

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1306136353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-408-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E 10TH AVE",
            "address_2": "SUITE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032853",
            "telephone_number": "801-408-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVRIES",
        "first_name": "MELISSA",
        "middle_name": "LYNNE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-12",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "UT",
            "license": "7449978-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.