Individual provider Active NPI

Daniel James Reis, PHD

  • Clinical Psychologist
  • Aurora, CO
National Provider Identifier
1124736053
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY.0006002 Issued in CO
Practice address
1700 Wheeling St # G-3116M
Aurora, CO 80045-7211
Phone
(720) 857-5770
NPI assigned
Nov 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY.0006002 CO Primary

Addresses

Primary practice location

1700 Wheeling St # G-3116M
Aurora, CO 80045-7211

Mailing address

5670 Dayton St
Denver, CO 80238-4186
Phone (509) 760-6475

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

LicenseStateTypeSpecialty
PSY.0006002COMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1124736053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5670 DAYTON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802384186",
            "telephone_number": "509-760-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 WHEELING ST # G-3116M",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457211",
            "telephone_number": "720-857-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIS",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-09",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0006002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.