Active NPI
Fred M Patrizi, PHD
- Clinical Neuropsychologist
- Norman, OK
National Provider Identifier
1104861988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 584
- Practice address
- 419 W Gray St
Norman, OK 73069-7117 - Phone
- (405) 321-3499
- Fax
- (405) 364-5379
- NPI assigned
- Jun 17, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 584 | OK | |
| Clinical Neuropsychologist | 103G00000X | 584 | OK | Primary |
| Psychologist | 103T00000X | 584 | OK |
Addresses
Primary practice location
419 W Gray St
Norman, OK 73069-7117
Mailing address
PO Box 1729
Norman, OK 73070-1729
Phone (405) 321-3499
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00323812 | Other | OK | RR MEDICARE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 584 | OK | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191456000000",
"number": "1104861988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1729",
"city": "NORMAN",
"state": "OK",
"postal_code": "730701729",
"telephone_number": "405-321-3499",
"fax_number": "405-364-5379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "419 W GRAY ST",
"city": "NORMAN",
"state": "OK",
"postal_code": "730697117",
"telephone_number": "405-321-3499",
"fax_number": "405-364-5379"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATRIZI",
"first_name": "FRED",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-17",
"last_updated": "2007-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OK",
"license": "584",
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "OK",
"license": "584",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OK",
"license": "584",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00323812",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norman, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.