JARED AUSTIN FULGHAM (NPI# 1659932275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659932275 |
| Entity Type | Individual |
| Full Name | JARED AUSTIN FULGHAM |
| Credential | CCC-SLP |
| Practice Address |
6410 Old Main Hl Logan UT 84322-6410 |
| Practice Telephone | 4357971375 |
| Practice Fax Number | 8443085865 |
| Mailing Telephone | 4357971375 |
| Mailing Fax Number | 8443085865 |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2019-06-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 9451387-4102 | UT | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | STATE LICENSE | 9451387-4102 | 01 |
| ID | STATE LICENSE | SLP-3236 | 01 |
| Street Address |
6410 OLD MAIN HL |
| City | LOGAN |
| State | UT |
| Zip Code | 84322-6410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649475633 | Amy Ann Porter | Audiologist | 6410 Old Main Hl, Logan, UT 84322-6410 | 2007-06-19 |
| 1356958508 | Sharon V Fairbourn | Speech-Language Pathologist | 6410 Old Main Hl, Logan, UT 84322-6410 | 2020-09-30 |
| 1922564897 | Angela G Anderson | Speech-Language Pathologist | 6410 Old Main Hl, Logan, UT 84322-6410 | 2019-02-15 |
| 1235374984 | Utah State University | Speech-Language Pathologist | 6410 Old Main Hl, Logan, UT 84322-6410 | 2008-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447706007 | Conner Andrews | Physician Assistant | 7425 Old Main Hill, Logan, UT 84322 | 2016-09-01 |
| 1841743515 | Kali Leanne Markle | Audiologist | 2620 Old Main Hl, Logan, UT 84322 | 2016-07-29 |
| 1043670011 | Paul Bryan Beachem Iv | Specialist/Technologist | 7400 Old Main Hill, Dale Mildenberger Sports Medicine Complex, Logan, UT 84322 | 2016-03-03 |
| 1508387176 | Matthew Steven Buckner | Specialist/Technologist | 7400 Old Main Hl, Logan, UT 84322 | 2017-07-04 |
| 1386776730 | Utah State University | Psychologist | 2810 Old Main Hl, Logan, UT 84322 | 2007-03-12 |
| 1366971368 | Caleigh Goode | Specialist/Technologist | 7425 Old Main Hill Athletic Training Room, Logan, UT 84322-0001 | 2017-06-05 |
| 1639319775 | Vicki L. Simonsmeier | Speech-Language Pathologist | Department of Communicative Disorders, 1000 Old Main Hill, Logan, UT 84322-0001 | 2009-03-03 |
| 1730246299 | George Christopher Wootton | Nurse Practitioner | 6802 Old Main Hl, Utah State University, Logan, UT 84322-0001 | 2007-01-03 |
| 1356373807 | Utah State University, Center for Persons With Disabilities | Day Training, Developmentally Disabled Services | 6810 Old Main Hl, Logan, UT 84322-0001 | 2006-07-07 |
| 1801878095 | James Walter Davis | Emergency Medicine | 9100 Old Main Hill, 850 East 1200 North, Logan, UT 84322-0001 | 2005-11-15 |
| Find all providers in zip 84322 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568093110 | Megan Fowler | Speech-Language Pathologist | 1 Middleschool Dr, Logan, OH 43138-9763 | 2020-02-03 |
| 1033693445 | Megan Israelsen | Speech-Language Pathologist | 356 N 300 W Apt 6, Logan, UT 84321-3855 | 2018-09-20 |
| 1649634346 | Steffanie Reeder | Speech-Language Pathologist | 4750 Hollow Rd, Logan, UT 84321-7917 | 2016-04-08 |
| 1841693470 | Laurie Cummings | Speech-Language Pathologist | 445 N Market St, Logan, OH 43138-1201 | 2014-09-26 |
| 1679973796 | Stacie Dawn Vecchiarelli | Speech-Language Pathologist | 8864 State Route 664 N, Logan, OH 43138-9356 | 2014-08-26 |
| 1043610363 | Kirsten Carr | Speech-Language Pathologist | 2019 E Front St, Logan, OH 43138-9678 | 2014-08-25 |
| 1518242106 | Deborah Lynn Amundson | Speech-Language Pathologist | 1000 Old Main Hill, Logan, UT 84322-1000 | 2011-10-15 |
| 1851605125 | Arron W Preston | Speech-Language Pathologist | 6800 Old Main Hill, Center for Persons With Disabilities, Logan, UT 84322-6800 | 2010-07-29 |
| 1376857508 | Tobey Fields | Speech-Language Pathologist | Utah State University, 1000 Old Main Hill, Logan, UT 84322-1000 | 2010-07-29 |
| 1639319775 | Vicki L. Simonsmeier | Speech-Language Pathologist | Department of Communicative Disorders, 1000 Old Main Hill, Logan, UT 84322-0001 | 2009-03-03 |
| Find all providers in LOGAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.