Individual provider Active NPI

Gary Douglas Lovejoy, PH.D.

  • Psychologist
  • Tempe, AZ
National Provider Identifier
1083716575
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
795 Issued in AZ
Practice address
4500 S Lakeshore Dr Ste 415
Tempe, AZ 85282-7056
Phone
(480) 756-1669
Fax
(480) 756-2132
NPI assigned
Sep 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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 795 AZ Primary

Addresses

Primary practice location

4500 S Lakeshore Dr Ste 415
Tempe, AZ 85282-7056

Mailing address

4500 S Lakeshore Dr Ste 415
Tempe, AZ 85282-7056
Phone (480) 756-1669

Other identifiers 1

IdentifierTypeStateIssuer
AZ0134480OtherAZBLUE CROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
795AZMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1157328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083716575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 S LAKESHORE DR STE 415",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827056",
            "telephone_number": "480-756-1669",
            "fax_number": "480-756-2132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 S LAKESHORE DR STE 415",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827056",
            "telephone_number": "480-756-1669",
            "fax_number": "480-756-2132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVEJOY",
        "first_name": "GARY",
        "middle_name": "DOUGLAS",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "AZ0134480",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.