Edward R Christophersen, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

R0145 Issued in MO

Practice address

5520 College Blvd
Children's Mercy Specialty Center, S. 130
Overland Park, KS 66211

Phone

(913) 696-8261

Fax

(913) 696-8395

NPI assigned

May 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144271685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9853 ROSEWOOD DR",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662073229",
            "telephone_number": "913-383-3936",
            "fax_number": "913-383-2498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 COLLEGE BLVD",
            "address_2": "CHILDREN'S MERCY SPECIALTY CENTER, S. 130",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66211",
            "telephone_number": "913-696-8261",
            "fax_number": "913-696-8395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOPHERSEN",
        "first_name": "EDWARD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "R0145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Christine M Boylan M.D. LLC
• Matthew M Christopher, PTA
• Melissa Ruth Church, P.T.
• Samantha Ciani
• Dale L Cipra, D.D.S.
• Cira Maria Garcia-Ferrer MD LLC
• Circle Care Services KS LLC

• Clinical Psychologist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Clinical Psychologist in Kansas

• 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.