Gregory W Gerritsen, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1209 Issued in CO

Practice address

2501 Walnut St
Suite 202
Boulder, CO 80302-5751

Phone

(303) 473-4433

Fax

(303) 499-2217

NPI assigned

Oct 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Foothills Psychological Group

  • Clinical Psychologist
  • Boulder, CO
  • NPI 1699098194
  NPD (past) Authorized official

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193097600000",
    "number": "1083795686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1062 LOVE CT",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032975",
            "telephone_number": "303-473-4433",
            "fax_number": "303-499-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 WALNUT ST",
            "address_2": "SUITE 202",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025751",
            "telephone_number": "303-473-4433",
            "fax_number": "303-499-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERRITSEN",
        "first_name": "GREGORY",
        "middle_name": "W",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "1209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07012099",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerald B Savory DDS PC
• Gerald Chitters MD PLLC
• Michele L. Gerard, PH.D.
• Daniel J Gerber, M.D.
• Zachary Gergely
• Jennie J Gershater, L.M.T, MA
• Ashya Marie Gertler
• Christie Gestal, MA, LPC
• Dean Gestal
• Gestalt Center for Growth and Training LLC

• Clinical Psychologist in Boulder, CO
• Providers in Boulder, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.