Active NPI
John Garrison, PHD
- Psychologist
- Peabody, MA
National Provider Identifier
1104849678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1731
- Practice address
- 1 Saint Lo Dr
Peabody, MA 01960-3723 - Phone
- (978) 535-2370
- NPI assigned
- Jul 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1731 | MA | Primary |
Addresses
Primary practice location
1 Saint Lo Dr
Peabody, MA 01960-3723
Mailing address
1 Saint Lo Dr
Peabody, MA 01960-3723
Phone (978) 535-2370
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0500810 | Medicaid | MA |
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1731 | MA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186444800000",
"number": "1104849678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 SAINT LO DR",
"city": "PEABODY",
"state": "MA",
"postal_code": "019603723",
"telephone_number": "978-535-2370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 SAINT LO DR",
"city": "PEABODY",
"state": "MA",
"postal_code": "019603723",
"telephone_number": "978-535-2370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARRISON",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2007-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "1731",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0500810",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peabody, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.