Active NPI
Rodrigo Veas-Wall, PH.D.
- Psychologist
- Provo, UT
National Provider Identifier
1740699453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 95249182501
- Practice address
- 1355 N University Ave Ste 200
Provo, UT 84604-2721 - Phone
- (801) 221-0223
- NPI assigned
- Aug 6, 2014
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 95249182501 | UT | Primary |
Addresses
Primary practice location
1355 N University Ave Ste 200
Provo, UT 84604-2721
Mailing address
1355 N University Ave Ste 200
Provo, UT 84604-2721
Phone (801) 636-5414
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 |
|---|---|---|---|
| 95249182501 | UT | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Clinical Management | Psychologist | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459123200000",
"number": "1740699453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1355 N UNIVERSITY AVE STE 200",
"city": "PROVO",
"state": "UT",
"postal_code": "846042721",
"telephone_number": "801-636-5414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1355 N UNIVERSITY AVE STE 200",
"city": "PROVO",
"state": "UT",
"postal_code": "846042721",
"telephone_number": "801-221-0223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VEAS-WALL",
"first_name": "RODRIGO",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-06",
"last_updated": "2016-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "UT",
"license": "95249182501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.