Individual provider Active NPI

Marvin Lawrence Denburg, PHD

  • Clinical Psychologist
  • Iowa City, IA
National Provider Identifier
1144330226
Registry record updated May 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5281-0 Issued in NY
Practice address
2101 Act Circle
Suite 202
Iowa City, IA 52245
Phone
(319) 337-6483
Fax
(319) 337-4208
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2009

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 5281-0 NY Primary

Addresses

Primary practice location

2101 Act Circle
Suite 202
Iowa City, IA 52245

Mailing address

2101 Act Circle
Suite 202
Iowa City, IA 52245
Phone (319) 337-6483

Other identifiers 1

IdentifierTypeStateIssuer
01625209MedicaidNY

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
005281NYMDMental Health Counselor
5281-0NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Vernon P. Varner, M.D., J.D., a Professional Corporation Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241136000000",
    "number": "1144330226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 ACT CIRCLE",
            "address_2": "SUITE 202",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "52245",
            "telephone_number": "319-337-6483",
            "fax_number": "319-337-4208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 ACT CIRCLE",
            "address_2": "SUITE 202",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "52245",
            "telephone_number": "319-337-6483",
            "fax_number": "319-337-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENBURG",
        "first_name": "MARVIN",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2009-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "5281-0",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01625209",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2009; 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.