Active NPI
H Gray Otis, PHD
- Professional Counselor
- West Jordan, UT
National Provider Identifier
1508822321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 5740241-6004
- Practice address
- 8817 Redwood Rd
West Jordan, UT 84088-9271 - Phone
- (801) 748-2270
- Fax
- (801) 748-2271
- NPI assigned
- Apr 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 5740241-6004 | UT | Primary |
Addresses
Primary practice location
8817 Redwood Rd
West Jordan, UT 84088-9271
Mailing address
3437 Bear Canyon LN
Cedar Hills, UT 84062-8014
Phone (801) 885-8585
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5740241-6004 | UT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508822321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3437 BEAR CANYON LN",
"city": "CEDAR HILLS",
"state": "UT",
"postal_code": "840628014",
"telephone_number": "801-885-8585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8817 REDWOOD RD",
"city": "WEST JORDAN",
"state": "UT",
"postal_code": "840889271",
"telephone_number": "801-748-2270",
"fax_number": "801-748-2271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTIS",
"first_name": "H",
"middle_name": "GRAY",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "UT",
"license": "5740241-6004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.