Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jared Austin Fulgham, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1659932275

Jared Austin Fulgham, CCC-SLP is a Qualified Speech Language Pathologist in Logan, Utah. Qualified in 2015, 11 years ago. Practices with Utah State University, a 10-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
11
Licensed in
UT
In the registry since
2019
What do these letters mean?
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

6410 Old Main Hl
Logan, UT 84322-6410
Phone: (435) 797-1375
Fax: (844) 308-5865
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 9451387-4102 (UT)

Record details

NPI number1659932275
Entity typeIndividual (Type 1)
GenderMale
Credentials CCC-SLP
Sole proprietorNo
NPI enumeratedJune 25, 2019
Last updated in NPPESJune 25, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Utah State University — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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