Alex Eddy, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

11833527-2506 Issued in UT

Practice address

4933 S 1500 W Ste 210
Riverdale, UT 84405-7738

Phone

(801) 655-4950

NPI assigned

May 26, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Chrysalis Utah, LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Orem, UT
  • NPI 1891898045

  Behavior Analyst

  NPD (past)

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1649628017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1443 W 800 N STE 103",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840572878",
            "telephone_number": "801-655-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4933 S 1500 W STE 210",
            "city": "RIVERDALE",
            "state": "UT",
            "postal_code": "844057738",
            "telephone_number": "801-655-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDDY",
        "first_name": "ALEX",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-26",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "UT",
            "license": "11833527-2506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luke Doxey
• Todd Thomas Doxey, D.C, M.P.H.
• Derek Dugan, RBT
• McKinley Lynn Duncan
• Sarah Durbano
• Kelly Ensign Ehlers, CMHC
• Elevation Physical Therapy
• Empowered Bodywork & Wellness
• Diamantina Jean Esquivel, RBT
• Eye Pros of Ogden

• All providers in Riverdale, UT
• Behavior Analyst in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.