Active NPI
Kimberly Ruth Walsh, PSY.D.
- Clinical Neuropsychologist
- South Ogden, UT
National Provider Identifier
1699750018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 117391-2501
- Practice address
- 1452 East Ridgeline Drive
Suite 151
South Ogden, UT 84405 - Phone
- (801) 690-0353
- Fax
- (801) 479-7020
- NPI assigned
- Dec 8, 2005
- Last updated
- Jul 30, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 117391-2501 | UT | Primary |
| Clinical Psychologist | 103TC0700X | 117391-2501 | UT |
Addresses
Primary practice location
1452 East Ridgeline Drive
Suite 151
South Ogden, UT 84405
Mailing address
PO Box 150214
Ogden, UT 84415-0214
Phone (801) 690-0353
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)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Navin K Varma MD PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375142400000",
"number": "1699750018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 150214",
"city": "OGDEN",
"state": "UT",
"postal_code": "844150214",
"telephone_number": "801-690-0353",
"fax_number": "801-479-7020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1452 EAST RIDGELINE DRIVE",
"address_2": "SUITE 151",
"city": "SOUTH OGDEN",
"state": "UT",
"postal_code": "84405",
"telephone_number": "801-690-0353",
"fax_number": "801-479-7020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSH",
"first_name": "KIMBERLY",
"middle_name": "RUTH",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-12-08",
"last_updated": "2013-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "UT",
"license": "117391-2501",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "UT",
"license": "117391-2501",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.