Individual provider Active NPI

Melissa Jean Carris, PH.D.

  • Clinical Psychologist
  • Grand Junction, CO
National Provider Identifier
1245318484
Registry record updated May 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2831 Issued in CO
Practice address
743 Horizon CT
Suite 368
Grand Junction, CO 81506-8701
Phone
(970) 712-9797
Fax
(970) 241-9292
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2014

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 2831 CO Primary

Addresses

Primary practice location

743 Horizon CT
Suite 368
Grand Junction, CO 81506-8701

Mailing address

743 Horizon CT
Suite 368
Grand Junction, CO 81506-8701
Phone (970) 712-9797

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
I20110127001050 CO Practitioner - Clinical Psychologist 9931388584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Cincinnati College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

743 Horizon CT
Suite 368
Grand Junction, CO 81506-8741
Phone (970) 712-9797

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carris Psychological Services PC Clinical CurrentSince Oct 3, 2010 Accepting new patients

Locations

743 Horizon Ct
Ste 368
Grand Junction, CO 81506
Phone (970) 712-9797

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399593600000",
    "number": "1245318484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 HORIZON CT",
            "address_2": "SUITE 368",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815068701",
            "telephone_number": "970-712-9797",
            "fax_number": "970-241-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 HORIZON CT",
            "address_2": "SUITE 368",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815068701",
            "telephone_number": "970-712-9797",
            "fax_number": "970-241-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRIS",
        "first_name": "MELISSA",
        "middle_name": "JEAN",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2014-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "2831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.