Active NPI
Ronald L. Willcoxon, PH.D.
- Psychologist
- Phoenix, AZ
National Provider Identifier
1003947698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3018
- Practice address
- 18647 N 20TH Street
Phoenix, AZ 85024-3074 - Phone
- (602) 867-9660
- Fax
- (602) 867-2762
- NPI assigned
- Mar 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3018 | AZ | Primary |
Addresses
Primary practice location
18647 N 20TH Street
Phoenix, AZ 85024-3074
Mailing address
18647 N 20TH St
Phoenix, AZ 85024-3074
Phone (602) 867-9660
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 732728 | Medicaid | AZ |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3018 | AZ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Behavioral Health Services, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1003947698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18647 N 20TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850243074",
"telephone_number": "602-867-9660",
"fax_number": "602-867-2762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18647 N 20TH STREET",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850243074",
"telephone_number": "602-867-9660",
"fax_number": "602-867-2762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLCOXON",
"first_name": "RONALD",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-08",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AZ",
"license": "3018",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "732728",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.