Individual provider Active NPI

Troy Jonathan Faddis, LMFT

  • Marriage & Family Therapist
  • Richfield, UT
National Provider Identifier
1861608416
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
49897413902 Issued in UT
Practice address
72 W Patriot Way Unit 1139
Richfield, UT 84701-1888
Phone
(435) 200-3422
Fax
(435) 836-2274
NPI assigned
May 14, 2007
Last updated
Nov 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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 49897413902 UT Primary

Addresses

Primary practice location

72 W Patriot Way Unit 1139
Richfield, UT 84701-1888

Mailing address

72 W Patriot Way Unit 1139
Richfield, UT 84701-1888
Phone (435) 200-3422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20250214000751 UT Practitioner - Marriage and Family Therapist 2860922242 Receives reassigned benefits from 1 practitioner
Practice locations: Richfield, UT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
49897413902UTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Troy Faddis, LMFT - PLLC Marriage & Family Therapist CurrentSince Nov 24, 2024 Accepting new patients

Locations

72 W Patriot Way
Unit 1139
Richfield, UT 84701
Phone (435) 200-3422

Practitioners & affiliated clinicians

Practitioners 1

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.

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1861608416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 W PATRIOT WAY UNIT 1139",
            "city": "RICHFIELD",
            "state": "UT",
            "postal_code": "847011888",
            "telephone_number": "435-200-3422",
            "fax_number": "435-836-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 W PATRIOT WAY UNIT 1139",
            "city": "RICHFIELD",
            "state": "UT",
            "postal_code": "847011888",
            "telephone_number": "435-200-3422",
            "fax_number": "435-836-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADDIS",
        "first_name": "TROY",
        "middle_name": "JONATHAN",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "49897413902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, UT

Sources for this page

Verify at the official NPI Registry.