NPIMap

Organization Active NPI

Healthy Brain Aging, LLC

  • Clinical Psychologist
  • Scottsdale, AZ
National Provider Identifier
1700437506
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
HEALTHY BRAIN AGING, LLC
Practice address
14200 N Northsight Blvd Ste 100
Scottsdale, AZ 85260-3947
Phone
(480) 729-9610
Fax
(480) 500-8345
NPI assigned
Sep 23, 2019
Last updated
Feb 26, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Authorized official

Name
Emily A Fager
Title
Director of Operations
Phone
(480) 729-9610

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary
Neurology Physician 2084N0400X NU

Addresses

Primary practice location

14200 N Northsight Blvd Ste 100
Scottsdale, AZ 85260-3947

Mailing address

14200 N Northsight Blvd Ste 100
Scottsdale, AZ 85260-3947
Phone (480) 729-9610

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address efager@smartbrainaging.com Direct

National Provider Directory

National Provider Directory

Locations

14200 N Northsight Blvd
Ste 100
Scottsdale, AZ 85260
Phone (480) 729-9610

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1700437506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14200 N NORTHSIGHT BLVD STE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603947",
            "telephone_number": "480-729-9610",
            "fax_number": "480-500-8345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14200 N NORTHSIGHT BLVD STE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603947",
            "telephone_number": "480-729-9610",
            "fax_number": "480-500-8345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY BRAIN AGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-23",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A",
        "authorized_official_last_name": "FAGER",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "480-729-9610"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "efager@smartbrainaging.com",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Email",
            "address_1": "14200 N Northsight Blvd Ste 100",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852603947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.