Individual provider Active NPI

Joseph Fair, PH.D.

  • Psychologist
  • Provo, UT
National Provider Identifier
1376919381
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
9469684-2501 Issued in UT
Practice address
750 N Freedom Blvd
Provo, UT 84601-1677
Phone
(801) 373-4760
Fax
(801) 373-0639
NPI assigned
Aug 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 9469684-2501 UT Primary

Addresses

Primary practice location

750 N Freedom Blvd
Provo, UT 84601-1677

Mailing address

750 N Freedom Blvd
Provo, UT 84601-1677
Phone (801) 373-4760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9469684-2501UTMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wasatch Behavioral Health Special Service District CurrentSince Mar 7, 2017 Accepting new patients
Ihc Health Services Inc CurrentSince May 1, 2017 Accepting new patients
Ihc Health Services, Inc. CurrentSince May 1, 2017 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Wasatch Behavioral Health Special Service District CurrentSince Mar 7, 2017 Accepting new patients
Yakima Neuropsychology PLLC Current Accepting new patients
Resolutions, Inc. Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

98 N 1100 E
Ste 103
American Fork, UT 84003
Phone (801) 492-2330

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

1157 N 300 W
Ste 201
Provo, UT 84604
Phone (801) 357-1200

1157 N 300 W
Provo, UT 84604
Phone (801) 357-1200

750 N Freedom Blvd
Provo, UT 84601
Phone (801) 373-0639

Organizations & group practices 8

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": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1376919381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N FREEDOM BLVD",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011677",
            "telephone_number": "801-373-4760",
            "fax_number": "801-373-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N FREEDOM BLVD",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011677",
            "telephone_number": "801-373-4760",
            "fax_number": "801-373-0639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIR",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-12",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "UT",
            "license": "9469684-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.