Organization Active NPI

New Peaks Neuropsychology, PLLC

  • Clinical Neuropsychologist
  • Boulder, CO
National Provider Identifier
1083354633
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
NEW PEAKS NEUROPSYCHOLOGY, PLLC
Practice address
777 29TH St Ste 200
Boulder, CO 80303-2316
Phone
(303) 200-4780
NPI assigned
Mar 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Authorized official

Name
Jessica Koepf
Title
Billing Contracting Manager
Phone
(303) 444-3443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X Primary

Addresses

Primary practice location

777 29TH St Ste 200
Boulder, CO 80303-2316

Mailing address

PO Box 273336
Fort Collins, CO 80527-3336
Phone (303) 444-3443

National Provider Directory

National Provider Directory

Locations

777 29th St
Ste 200
Boulder, CO 80303
Phone (303) 200-4780

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": "1648684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1083354633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 273336",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805273336",
            "telephone_number": "303-444-3443",
            "fax_number": "970-221-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 29TH ST STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032316",
            "telephone_number": "303-200-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW PEAKS NEUROPSYCHOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "KOEPF",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "BILLING CONTRACTING MANAGER",
        "authorized_official_telephone_number": "303-444-3443"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.