Individual provider Active NPI

Amy Rapp, PSY.D.

  • Psychologist
  • Colorado Springs, CO
National Provider Identifier
1174058176
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY.0004603 Issued in CO
Practice address
2860 S Circle Dr Ste 109
Colorado Springs, CO 80906-4195
Phone
(179) 540-2146
NPI assigned
Apr 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY004077 GA
Forensic Psychologist 103TF0200X PSY004077 GA
Psychologist 103T00000X PSY.0004603 CO Primary

Addresses

Primary practice location

2860 S Circle Dr Ste 109
Colorado Springs, CO 80906-4195

Mailing address

2860 S Circle Dr Ste 109
Colorado Springs, CO 80906-4195
Phone (179) 540-2146

Other practice location 1

6885 Mesa Ridge Parkway
# 141
Fountain, CO 80817
Phone (443) 867-8104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180124000460 CO Practitioner - Clinical Psychologist 7618236456 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY.0004603COMDPsychologist
PSY004077GAMDForensic Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center, LLC Psychologist CurrentSince Jan 1, 2022 Accepting new patients
Family Care Center, LLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

2860 S Circle Dr
Ste 109
Colorado Springs, CO 80906
Phone 71954021004002

3715 Parkmoor Village Dr
Ste 102
Colorado Springs, CO 80917
Phone (719) 540-2127

Organizations & group practices 2

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": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1174058176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 S CIRCLE DR STE 109",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064195",
            "telephone_number": "179-540-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 S CIRCLE DR STE 109",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064195",
            "telephone_number": "179-540-2146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6885 Mesa Ridge Parkway",
            "address_2": "# 141",
            "address_purpose": "LOCATION",
            "city": "Fountain",
            "state": "CO",
            "postal_code": "80817",
            "country_code": "US",
            "telephone_number": "443-867-8104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAPP",
        "first_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-27",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY004077",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "GA",
            "license": "PSY004077",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "PSY.0004603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.