Individual provider Active NPI

Margo Miles, PH.D.

  • Clinical Psychologist
  • Salt Lake City, UT
National Provider Identifier
1326190158
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
369759-2501 Issued in UT
Practice address
150 S 600 E Ste 10D
Salt Lake City, UT 84102-1961
Phone
(801) 328-9204
Fax
(801) 582-1392
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 369759-2501 UT Primary

Addresses

Primary practice location

150 S 600 E Ste 10D
Salt Lake City, UT 84102-1961

Mailing address

607 Elizabeth St
Salt Lake City, UT 84102-3905
Phone (801) 328-9204

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
I20191111001068 UT Practitioner - Clinical Psychologist 0446682611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

150 S 600
Suite 10D
Salt Lake City, UT 84102-1961
Phone 80132892043

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Margo Miles PHD PC CurrentSince Jan 1, 2018 Accepting new patients
Valley Behavioral Health Incorporated Clinical Past Accepting new patients

Locations

150 S 600 E
Ste 10D
Salt Lake City, UT 84102
Phone (801) 325-9204

Organizations & group practices 2

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1326190158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 ELIZABETH ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841023905",
            "telephone_number": "801-328-9204",
            "fax_number": "801-582-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S 600 E STE 10D",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021961",
            "telephone_number": "801-328-9204",
            "fax_number": "801-582-1392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "MARGO",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "369759-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.