Theresa M Gisi,, PH. D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

2396 Issued in CO

Practice address

17730 Smugglers Rd
Monument, CO 80132-8517

Phone

(719) 641-0222

Fax

(719) 623-0008

NPI assigned

Apr 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Theresa M Zumbrun Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401062400000",
    "number": "1235250754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6270 LEHMAN DR",
            "address_2": "SUITE 200B",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809181469",
            "telephone_number": "719-641-0222",
            "fax_number": "719-623-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17730 SMUGGLERS RD",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801328517",
            "telephone_number": "719-641-0222",
            "fax_number": "719-623-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GISI,",
        "first_name": "THERESA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2014-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CO",
            "license": "2396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "ZUMBRUN",
            "middle_name": "M",
            "prefix": "MISS",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• A J Gerathy Jr., DMD
• Karen Gershanov
• Jami Gilbert
• Tammy L Gill, LMT
• Stacie Gilmore
• Jamie Dahlgren Glover, M.D.
• Stephanie M Goddard
• Tiffany Lynn Goles, MSW, LMSW
• Samantha U Gonzales, DPT
• Lia Angelica Grandinetti, DDS

• Clinical Neuropsychologist in Monument, CO
• Providers in Monument, CO by specialty
• Clinical Neuropsychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2014; 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.