Individual provider Active NPI

Mark Howard Wright, PHD

  • Psychologist
  • Phoenix, AZ
National Provider Identifier
1063510451
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1092 Issued in AZ
Practice address
650 E Indian School Rd
Phoenix VA Medical Center
Phoenix, AZ 85012-1839
Phone
(602) 222-6491
Fax
(602) 212-2043
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1092 AZ Primary

Addresses

Primary practice location

650 E Indian School Rd
Phoenix VA Medical Center
Phoenix, AZ 85012-1839

Mailing address

14632 S 44TH St
Phoenix, AZ 85044-6006
Phone (480) 705-7595

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

LicenseStateTypeSpecialty
1092AZMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063510451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14632 S 44TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446006",
            "telephone_number": "480-705-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 E INDIAN SCHOOL RD",
            "address_2": "PHOENIX VA MEDICAL CENTER",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121839",
            "telephone_number": "602-222-6491",
            "fax_number": "602-212-2043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "MARK",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "1092",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 8, 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.

Verify at the official NPI Registry.