Organization Active NPI

Rehabilitation Psychology Services P S

  • Psychologist
  • Bellingham, WA
National Provider Identifier
1013049378
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
REHABILITATION PSYCHOLOGY SERVICES P S
Practice address
801 Samish Way
Bellingham, WA 98229
Phone
(360) 255-2505
Fax
(360) 255-2504
NPI assigned
Mar 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Greg R Ford, PH.D.NPI 1740219153
Title
Partner
Phone
(360) 255-2505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

801 Samish Way
Bellingham, WA 98229

Mailing address

801 Samish Way
Bellingham, WA 98229-2940
Phone (360) 255-2505

Other practice location 1

12 Bellwether Way
Suite 223
Bellingham, WA 98225-2959
Phone (360) 255-2505 ext. 105

Other practice location 2

801 Samish Way
Bellingham, WA 98229
Phone (360) 255-2505 ext. 105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080923000650 WA Part B Supplier - Clinic/Group Practice 7416024070 Receives reassigned benefits from 2 practitioners
Practice locations: Bellingham, WA

National Provider Directory

National Provider Directory

Locations

12 Bellwether Way
Ste 223
Bellingham, WA 98225
Phone (360) 230-8202

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555459200000",
    "number": "1013049378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 SAMISH WAY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982292940",
            "telephone_number": "360-255-2505",
            "fax_number": "360-255-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 SAMISH WAY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98229",
            "telephone_number": "360-255-2505",
            "fax_number": "360-255-2504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Bellwether Way",
            "address_2": "Suite 223",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982252959",
            "country_code": "US",
            "telephone_number": "360-255-2505 x105",
            "fax_number": "360-255-2504",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Samish Way",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "98229",
            "country_code": "US",
            "telephone_number": "360-255-2505 x105",
            "fax_number": "360-255-2504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REHABILITATION PSYCHOLOGY SERVICES P S",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2019-04-17",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "360-255-2505",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.