Individual provider Active NPI

Eric C Powell, PSYD

  • Clinical Psychologist
  • Durango, CO
National Provider Identifier
1215038880
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY2927 Issued in CO
Practice address
2855 Main Ave Ste A105
Durango, CO 81301-5959
Phone
(970) 382-6690
Fax
(970) 382-0207
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PSY2927 CO Primary

Addresses

Primary practice location

2855 Main Ave Ste A105
Durango, CO 81301-5959

Mailing address

200 Jenkins Ranch Rd
Durango, CO 81301-9483
Phone (970) 247-2035

Other identifiers 1

IdentifierTypeStateIssuer
PSY2927OtherCOST LICENSE

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
I20070416000476 CO Practitioner - Clinical Psychologist 7810092145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

813 Main Ave
Suite 209
Durango, CO 81301-5478
Phone (970) 259-4048

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY2927COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eric Powell Consulting, LLC CurrentSince Jul 14, 2018 Accepting new patients

Locations

813 Main Ave
Ste 209
Durango, CO 81301
Phone (970) 259-4048

813 Main Ave
Ste 205
Durango, CO 81301
Phone (970) 259-4048

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215038880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 JENKINS RANCH RD",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813019483",
            "telephone_number": "970-247-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 MAIN AVE STE A105",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813015959",
            "telephone_number": "970-382-6690",
            "fax_number": "970-382-0207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "ERIC",
        "middle_name": "C",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY2927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST LICENSE",
            "identifier": "PSY2927",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.