Jon Edward Eggert, EDD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY.0002439 Issued in CO

Practice address

327 Colorado Ave
Pueblo, CO 81004-2005

Phone

(719) 948-7120

NPI assigned

Feb 10, 2021

Last updated

Mar 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1205428323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 COLORADO AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042005",
            "telephone_number": "719-948-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 COLORADO AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042005",
            "telephone_number": "719-948-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGGERT",
        "first_name": "JON",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "EDD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-10",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0002439",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CO",
            "license": "2439",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.