Individual provider Active NPI

Jamie Mecham, SLP

  • Speech-Language Pathologist
  • Logan, UT
National Provider Identifier
1992107312
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6166336-4102 Issued in UT
Practice address
1000 Old Main Hill
Logan, UT 84322-1000
Phone
(435) 797-5531
NPI assigned
Sep 17, 2014
Last updated
Sep 17, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 6166336-4102 UT Primary

Addresses

Primary practice location

1000 Old Main Hill
Logan, UT 84322-1000

Mailing address

1000 Old Main Hill
Logan, UT 84322-1000
Phone (435) 797-5531

Other identifiers 1

IdentifierTypeStateIssuer
6166336-4102OtherUTLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190103001712 UT Practitioner - Qualified Speech Language Pathologist 5294071783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah State UniversityGroup PAC ID 3476715491, 10 clinicians

Practice addresses (Care Compare)

6410 Old Main HL
Logan, UT 84322-6410
Phone (435) 797-1346

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6166336-4102UTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Utah State University Speech-Language Pathologist CurrentSince Oct 22, 2018 Accepting new patients
Utah State University CurrentSince Oct 22, 2018 Accepting new patients
Utah State University PastSince Dec 15, 2019 Accepting new patients
Usu Student Health & Wellness Past Accepting new patients

Locations

1000 Old Main Hl
Logan, UT 84322
Phone (435) 797-1346

6405 Old Main Hl
Logan, UT 84322
Phone (435) 797-3403

6410 Old Main Hl
Logan, UT 84322
Phone (435) 797-1346

6802 Old Main Hl
Logan, UT 84322
Phone (435) 797-1346

Organizations & group practices 4

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": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1992107312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 OLD MAIN HILL",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843221000",
            "telephone_number": "435-797-5531",
            "fax_number": "435-797-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 OLD MAIN HILL",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843221000",
            "telephone_number": "435-797-5531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MECHAM",
        "first_name": "JAMIE",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-17",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "UT",
            "license": "6166336-4102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "6166336-4102",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.