Individual provider Active NPI

David E Christian, PHD

  • Clinical Psychologist
  • Logan, UT
National Provider Identifier
1336273481
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
357927-2501 Issued in UT
Practice address
246 E 1260 N
Logan, UT 84341-7501
Phone
(435) 750-6300
Fax
(435) 753-8995
NPI assigned
Mar 14, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 357927-2501 UT Primary

Addresses

Primary practice location

246 E 1260 N
Logan, UT 84341-7501

Mailing address

246 E 1260 N
PO Box 6244
Logan, UT 84341-7501
Phone (435) 750-6300

Other identifiers 3

IdentifierTypeStateIssuer
345617OtherUTDMBA
62617OtherUTPEHP
107008370101OtherUTIHC

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
I20120523000667 UT Practitioner - Clinical Psychologist 7618130972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

629 S 575
Logan, UT 84321-5162
Phone (435) 512-1547

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
357927-2501UTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
David E Christian PHD PC Psychologist CurrentSince Jul 23, 2017 Accepting new patients

Locations

274 N Main St
Logan, UT 84321
Phone (435) 213-9278

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336273481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 E 1260 N",
            "address_2": "PO BOX 6244",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843417501",
            "telephone_number": "435-750-6300",
            "fax_number": "435-753-8995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 E 1260 N",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843417501",
            "telephone_number": "435-750-6300",
            "fax_number": "435-753-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIAN",
        "first_name": "DAVID",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "357927-2501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMBA",
            "identifier": "345617",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "62617",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHC",
            "identifier": "107008370101",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

Verify at the official NPI Registry.