Utah State University
Organization Active NPI Specialist · Logan, UT
NPI 1447715701 · NPPES record last updated Apr 24, 2026
Key facts
- NPI
- 1447715701
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- Legal business name
- UTAH STATE UNIVERSITY
- Practice address
- 6405 Old Main Hill
Logan, UT 84322-0001 - Phone
- (435) 797-7430
- Fax
- (844) 308-5865
- NPI assigned
- Jan 31, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- UTAH STATE UNIVERSITY
Authorized official
- Name
- Kathryn Clements
- Title
- Cehs Financial Officer
- Phone
- (435) 797-5830
Other NPIs on the same Medicare enrollment 4
Corporate family (same tax ID) 11
Practitioners 25
-
Megan E Bressel, PT
-
Jared Austin Fulgham, CCC-SLP
-
Michael Esteban Gerald, CMHC, LMHC, CRC
-
Maria Kleinstaeuber, PHD
-
Jamie Mecham, SLP
-
Andrea Suzette Page, AUD
-
John W Payne, PT
-
Cache Laurence Pitt, AUD
-
Tanner Egan Price, AUD
-
Tiffany Shelton, AUD
-
Joy Green, MS,OTR-L
-
Gary Tyler Lefevor, PHD
-
Rhea Palkhiwala, BCBA
-
Erik J Reinbergs, PHD
-
Martin J. Toohill, PH.D.
-
Joann T. Tschanz, PH.D.
-
Daniel Jacob Wagner, BCBA
-
Erin Elizabeth Wheatley, M.ED., BCBA, LBA
-
Dallas R Spencer, LMSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120508000468 | UT | Part B Supplier - Clinic/Group Practice | 3476715491 |
Receives reassigned benefits from 18 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Logan, UT |
National Provider Directory
- Tax ID family
- Utah State University
- Part of
- Utah State University
Locations
1000 Old Main Hl
Logan, UT 84322
Phone (435) 797-1346
6802 Old Main Hl
Logan, UT 84322
Phone (435) 797-1346
6410 Old Main Hl
Logan, UT 84322
Phone (435) 797-1346
3726 S 2400 W
Wellsville, UT 84339
Phone (435) 797-4200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | Yes |
Addresses
Primary practice location
6405 Old Main Hill
Logan, UT 84322-0001
Mailing address
6405 Old Main HL
Logan, UT 84322-6405
Phone (435) 797-4200
Other practice location 1
3726 S 2400 W
Wellsville, UT 84339
Phone (435) 797-4200
Other practice location 2
3580 South Hwy 89-91
Wellsville, UT 84339
Phone (435) 797-4200
Other names
- Sorenson Legacy Foundation Center for Clinical Excellence
Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.