Kent W Anderson, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

324469-2501 Issued in UT

Practice address

545 W 465 N
Suite 130
Providence, UT 84332-8003

Phone

(435) 752-7627

Fax

(435) 752-7802

NPI assigned

Mar 12, 2007

Last updated

Jan 26, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Kent W Anderson PHD PC

  • Clinical Psychologist
  • Providence, UT
  • NPI 1255662425
  Medicare reassignment Authorized official
• Bruce R. Johns, PH.D., P.C.

  • Clinical Psychologist
  • Logan, UT
  • NPI 1598216731
  NPD (past)

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264464000000",
    "number": "1932231016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 W 465 N",
            "address_2": "SUITE 130",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843328003",
            "telephone_number": "435-752-7627",
            "fax_number": "435-752-7802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 W 465 N",
            "address_2": "SUITE 130",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843328003",
            "telephone_number": "435-752-7627",
            "fax_number": "435-752-7802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KENT",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2010-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "324469-2501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "52082",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHC",
            "identifier": "107007866101",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMBA",
            "identifier": "292486",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION #",
            "identifier": "870621775",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDUCATORS MUTUAL INSURANC",
            "identifier": "870621775AN2",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allencrane, LLP (ABC Pediatric Dentistry & Orthodontics)
• Ty Bracken Aller
• Gregory J Allred, DO
• Heather B Allred, PA-C
• Darren V Anderson, M.D.
• Angel Home Hospice LLC
• Rachel Archibald, RBT
• Maeci Hicken Armstrong, RDN
• Andrea Arnell, PMHNP
• Jessica Anna Ash

• Clinical Psychologist in Providence, UT
• Providers in Providence, UT by specialty
• Clinical Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; 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.