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JARED AUSTIN FULGHAM CCC-SLP
NPI 1659932275
Speech-Language Pathologist in Logan, UT

Active since June 25, 2019Accepts Medicare Assignment
6410 OLD MAIN HL, LOGAN, UT 84322(435) 797-1375(844) 308-5865 Get Directions Write a Review

NPPES record last updated: June 25, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jared Austin Fulgham Ccc-slp NPPES

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

JARED AUSTIN FULGHAM CCC-SLP (NPI 1659932275) is an individual speech-language pathologist provider in Logan, Utah, licensed in Utah (9451387-4102) and active in the NPI registry since June 2019. He is a graduate of Other (2015).

NPPES Registry Identity

NPI1659932275
Entity TypeIndividualMale
Primary Taxonomy235Z00000X
Provider Legal NameJARED AUSTIN FULGHAMCredential: CCC-SLP
Location Address6410 OLD MAIN HLLogan, UT 84322-6410
Mailing Address6410 Old Main HlLogan, UT 84322-6410 · (435) 797-1375 · Fax (844) 308-5865
Phone(435) 797-1375
Fax(844) 308-5865
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateJune 25, 2019
✔ NPI 1659932275 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in UT · 9451387-4102
Definition
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.
6410 OLD MAIN HL, Logan, UT 84322
Open in Google Maps ↗

Other Identifiers 2

Other9451387-4102UT · State License
OtherSLP-3236ID · State License

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jared Austin Fulgham Ccc-slp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5597094284
PECOS Enrollment IDI20190905001244

Medicare Billing Reassignment

Medicare enrollment records show Jared Fulgham reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Utah State University
4.6 mi
Specialist
6405 OLD MAIN HILL
Logan, UT 84322
  • Reassigned Medicare billing, Utah enrollment
  • 22 clinicians in this Medicare group
NPI 1447715701 (435) 797-7430

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 10

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

DR. ANDREA SUZETTE PAGE AUD
Audiologist
6410 OLD MAIN HL
LOGAN, UT 84322
Cache County (435) 797-1374
UTAH STATE UNIVERSITY
Audiologist
6410 OLD MAIN HL
LOGAN, UT 84322
Cache County (435) 797-1346
MRS. KEELY MARIE PERKES MA, CCC-SLP
Speech-Language Pathologist
6410 OLD MAIN HL
LOGAN, UT 84322
Cache County (435) 797-4200
SHARON V FAIRBOURN CCC-SLP
Speech-Language Pathologist
6410 OLD MAIN HL
LOGAN, UT 84322
Cache County (435) 797-9234
DR. DAPHNE URSULA HARTZHEIM PH.D. CCC-SLP, BCBA
Speech-Language Pathologist
6410 OLD MAIN HL
LOGAN, UT 84322
Cache County (435) 797-1375
DR. AMY ANN PORTER AU.D., CCC-A
Audiologist
6410 OLD MAIN HL
LOGAN, UT 84322
Cache County (435) 797-1373
LAURA LEE BARDSLEY SCHMITT SLP
Speech-Language Pathologist
6410 OLD MAIN HL
LOGAN, UT 84322
Cache County (435) 797-1375
DR. TANNER EGAN PRICE AUD
Audiologist
6410 OLD MAIN HL
LOGAN, UT 84322
Cache County (435) 797-9234

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jared Fulgham's NPI number?

The NPI number for Jared Fulgham is 1659932275. It was assigned to this individual provider in the NPPES registry on June 25, 2019.

Where is Jared Fulgham located?

Jared Fulgham practices at 6410 Old Main Hl, Logan, UT 84322. The listed phone number is (435) 797-1375.

What is Jared Fulgham's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Jared Fulgham enrolled in Medicare?

Yes. Jared Fulgham is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jared Fulgham's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jared Fulgham reassigns Medicare benefits to Utah State University (Logan, UT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jared Fulgham's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jared Fulgham accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah, Select Health and University of Utah Health Plans list Jared Fulgham as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jared Fulgham was last updated on June 25, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.