Individual provider Active NPI

Jeffrey Ladd, LMFT

  • Marriage & Family Therapist
  • St George, UT
National Provider Identifier
1760529549
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
276187-3902 Issued in UT
Practice address
474 W 200 N
Suite 100
St George, UT 84770-4505
Phone
(435) 634-5600
Fax
(435) 986-8700
NPI assigned
Jan 31, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 276187-3902 UT Primary

Addresses

Primary practice location

474 W 200 N
Suite 100
St George, UT 84770-4505

Mailing address

474 W 200 N
Suite 300
St George, UT 84770-4505
Phone (435) 634-5600

Other identifiers 1

IdentifierTypeStateIssuer
276187-3902OtherUTSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241014003263 AR Practitioner - Marriage and Family Therapist 7618409780 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ozark Guidance Center, IncGroup PAC ID 7214833730, 34 clinicians
Arisa Health IncGroup PAC ID 2264853829, 65 clinicians

Practice addresses (Care Compare)

2508 SE 20TH St
Bentonville, AR 72712-4008
Phone (479) 273-9088

401 S 40TH St
Rogers, AR 72756-1802
Phone (479) 273-9088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
276187-3902UTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ozark Guidance Center, Inc CurrentSince Jun 29, 2024 Accepting new patients
Ozark Guidance Center, Inc CurrentSince Jun 29, 2024 Accepting new patients

Locations

2508 SE 20th St
Bentonville, AR 72712
Phone (479) 273-9088

1104 N College St
Huntsville, AR 72740
Phone (479) 738-2878

Organizations & group practices 3

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760529549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 W 200 N",
            "address_2": "SUITE 300",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847704505",
            "telephone_number": "435-634-5600",
            "fax_number": "435-986-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 W 200 N",
            "address_2": "SUITE 100",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847704505",
            "telephone_number": "435-634-5600",
            "fax_number": "435-986-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADD",
        "first_name": "JEFFREY",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "276187-3902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "276187-3902",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.