Kathryn J Waddell, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

112725-2501 Issued in UT

Practice address

8TH Ave C St
Salt Lake City, UT 84143-0001

Phone

(801) 408-5584

NPI assigned

Feb 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Center for Human Potential Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Salt Lake City, UT
  • NPI 1548239940
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Physician Group of Utah Inc

  • Specialist
  • South Jordan, UT
  • NPI 1477676930
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Logan, UT
  • NPI 1033489505
  NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Salt Lake City, UT
  • NPI 1366567588
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Center for Human Potential

  • Community/Behavioral Health Agency
  • Salt Lake City, UT
  • NPI 1366679441
  NPD (past)

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1891833257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-442-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8TH AVE C ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841430001",
            "telephone_number": "801-408-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDELL",
        "first_name": "KATHRYN",
        "middle_name": "J",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "UT",
            "license": "112725-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vyta LLC
• W Home Health Care Services
• Lauren Wacha, OTR
• Jessica Wacker
• David A Wada, MD
• Emily D Waddoups, RDCD
• Sarah Waddoups
• Wade Thomson
• Alessa Wade, RD
• Amanda Wade

• Clinical Neuropsychologist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Clinical Neuropsychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.