NPIMap

Individual provider Active NPI

David Alan Anson, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Salt Lake City, UT
National Provider Identifier
1992776223
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
963262352501 Issued in UT
Practice address
3703 W 6200 S
Salt Lake City, UT 84118-3749
Phone
(801) 963-4200
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 963262352501 UT
Clinical Child & Adolescent Psychologist 103TC2200X 963262352501 UT Primary

Addresses

Primary practice location

3703 W 6200 S
Salt Lake City, UT 84118-3749

Mailing address

3703 W 6200 S
Salt Lake City, UT 84118-3749

Other identifiers 3

IdentifierTypeStateIssuer
341626OtherUTDESERET MUTUAL
942938348AN3OtherUTEDUCATORS MUTUAL
107019848101OtherUTINTERMTN. HEALTH CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
963262352501UTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rise Behavioral and Mental Health Services, LLC Past Accepting new patients
Rise, Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1992776223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3703 W 6200 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841183749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 W 6200 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841183749",
            "telephone_number": "801-963-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSON",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "963262352501",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "UT",
            "license": "963262352501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DESERET MUTUAL",
            "identifier": "341626",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDUCATORS MUTUAL",
            "identifier": "942938348AN3",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERMTN. HEALTH CARE",
            "identifier": "107019848101",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.