ELIZA RACHELLE GEDGE PH.D., LP
NPI 1003197658
Psychologist - Clinical in Provo, UT

Q: What is Eliza Gedge's NPI number?

The NPI number for Eliza Gedge is 1003197658. It was assigned to this individual provider in the NPPES registry on September 8, 2011.

Q: What is Eliza Gedge's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Eliza Gedge was last updated on April 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 08, 2011PECOS Enrolled

750 N FREEDOM BLVD, PROVO, UT 84601(801) 373-0639(801) 373-0639 Get Directions Write a Review

NPPES record last updated: April 2, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 2, 2024, Aug 12, 2022, Jun 3, 2021 and 1 more (4 updates tracked since 2021).

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About Eliza Rachelle Gedge Ph.d., Lp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELIZA RACHELLE GEDGE PH.D., LP (NPI 1003197658) is an individual clinical provider in Provo, Utah, licensed in Utah (12966150-25801) and active in the NPI registry since September 2011. She is enrolled in Medicare PECOS and maintains a secondary practice location in Pontiac.

NPPES Registry Identity

NPI1003197658

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameELIZA RACHELLE GEDGECredential: PH.D., LP

Location Address750 N FREEDOM BLVDProvo, UT 84601-1677

Mailing Address750 N Freedom BlvdProvo, UT 84601-1677 · (801) 373-0639 · Fax (801) 373-0639

Phone(801) 373-0639

Fax(801) 373-0639

Sole ProprietorNo

Enumeration DateSeptember 8, 2011

Last NPPES UpdateApril 2, 20244 updates tracked since enumeration

NPPES CertifiedApril 2, 2024

✔ NPI 1003197658 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in UT · 12966150-25801

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedPsychologist · CounselingTaxonomy 103TC1900X · License 6301014858 (MI)

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License 12966150-2501 (UT)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

750 N FREEDOM BLVD, Provo, UT 84601

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Secondary Practice Location 1

Location 1114 Orchard Lake RdPontiac, MI 48341-2244 · Phone (248) 858-7766 ext. 277 · Fax (248) 858-7201

Other Identifiers 1

Medicaid1883825MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Utah, Select Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eliza Rachelle Gedge Ph.d., Lp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84601 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$166.03 typical visit price

range $54.34 – $166.03

Typical copayment $41.50 (range $13.58 – $41.50)

Most-billed visit code 99205

Established Patient

$96.35 typical visit price

range $17.23 – $135.20

Typical copayment $24.08 (range $4.30 – $33.80)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WASATCH MENTAL HEALTH

Clinic/Center (Adolescent and Children Mental Health)