Individual provider Active NPI

Alan L. Zohner, PH.D.

  • Clinical Neuropsychologist
  • Idaho Falls, ID
National Provider Identifier
1104934249
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY200 Issued in ID
Practice address
1842 1St St
Idaho Falls, ID 83401-4415
Phone
(208) 552-5707
Fax
(208) 552-5709
NPI assigned
Aug 28, 2006
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
Clinical Neuropsychologist 103G00000X PSY200 ID Primary

Addresses

Primary practice location

1842 1St St
Idaho Falls, ID 83401-4415

Mailing address

1842 1St St
Idaho Falls, ID 83401-4415
Phone (208) 552-5707

Other identifiers 2

IdentifierTypeStateIssuer
N5418OtherIDBLUE CROSS
000010140979OtherIDBLUE SHIELD

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

LicenseStateTypeSpecialty
PSY200IDMDClinical Neuropsychologist

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104934249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1842 1ST ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014415",
            "telephone_number": "208-552-5707",
            "fax_number": "208-552-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1842 1ST ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014415",
            "telephone_number": "208-552-5707",
            "fax_number": "208-552-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOHNER",
        "first_name": "ALAN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "ID",
            "license": "PSY200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "N5418",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010140979",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.