Active NPI
Taylor Zadonowicz
- Psychologist
- Provo, UT
National Provider Identifier
1336705318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 13518903-2501
- Practice address
- 1300 E Center St
Provo, UT 84606-3554 - Phone
- (801) 344-4215
- NPI assigned
- May 15, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 13518903-2501 | UT | Primary |
Addresses
Primary practice location
1300 E Center St
Provo, UT 84606-3554
Mailing address
1300 E Center St
Provo, UT 84606-3554
Phone (480) 313-9346
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13518903-2501 | UT | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Utah | Current | Accepting new patients | |
| Goodwill Industries of Santa Clara County | Past | Accepting new patients |
Locations
1300 E Center St
Provo, UT 84606
Phone (801) 344-4215
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.
-
- Psychiatric Hospital
- Provo, UT
- NPI 1811978620
-
- Community/Behavioral Health Agency
- San Jose, CA
- NPI 1750751780
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726099200000",
"number": "1336705318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 E CENTER ST",
"city": "PROVO",
"state": "UT",
"postal_code": "846063554",
"telephone_number": "480-313-9346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 E CENTER ST",
"city": "PROVO",
"state": "UT",
"postal_code": "846063554",
"telephone_number": "801-344-4215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZADONOWICZ",
"first_name": "TAYLOR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-15",
"last_updated": "2024-09-12",
"certification_date": "2024-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "UT",
"license": "13518903-2501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.