Active NPI
Jerry Sapan, PH.D.
- Psychologist
- Portland, ME
National Provider Identifier
1225320401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS901
- Practice address
- 205 Ocean Ave
Portland, ME 04103-5712 - Phone
- (207) 773-7993
- NPI assigned
- May 6, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS901 | ME | Primary |
| Clinical Psychologist | 103TC0700X | PS901 | ME |
Addresses
Primary practice location
205 Ocean Ave
Portland, ME 04103-5712
Mailing address
205 Ocean Ave
Portland, ME 04103-5712
Phone (207) 773-7993
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304640000000",
"number": "1225320401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 OCEAN AVE",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041035712",
"telephone_number": "207-773-7993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 OCEAN AVE",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041035712",
"telephone_number": "207-773-7993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAPAN",
"first_name": "JERRY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-05-06",
"last_updated": "2011-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "ME",
"license": "PS901",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "ME",
"license": "PS901",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.