M Ford McBride, PHD, PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

109867-2501 Issued in UT

Legal business name

M FORD MCBRIDE, PHD, PC

Practice address

1055 N 300 W
414
Provo, UT 84604-3344

Phone

(801) 357-7757

Fax

(801) 357-8100

NPI assigned

Jun 3, 2008

Last updated

Jul 1, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Max Ford McBride, PHDNPI 1083793467

Title

President

Phone

(801) 357-7757

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Max Ford McBride, PH.D.

  • Clinical Psychologist
  • Provo, UT
  • NPI 1083793467
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1407015787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 300 W",
            "address_2": "414",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043344",
            "telephone_number": "801-357-7757",
            "fax_number": "801-357-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N 300 W",
            "address_2": "414",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043344",
            "telephone_number": "801-357-7757",
            "fax_number": "801-357-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M FORD MCBRIDE, PHD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-03",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "MCBRIDE",
        "authorized_official_first_name": "MAX",
        "authorized_official_middle_name": "FORD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-357-7757",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "109867-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Provo, UT
• Providers in Provo, UT by specialty
• Clinical Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.