Active NPI
Meghan R Wilde, PSY.D.
- Clinical Psychologist
- Denver, CO
National Provider Identifier
1255537130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY0004167
- Practice address
- 4455 E 12TH Ave
Denver, CO 80220-2415 - Phone
- (303) 504-7700
- NPI assigned
- Jun 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY0004167 | CO | Primary |
Addresses
Primary practice location
4455 E 12TH Ave
Denver, CO 80220-2415
Mailing address
4455 E 12TH Ave
Denver, CO 80220-2415
Phone (303) 504-7700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2024 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY0004167 | CO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428537600000",
"number": "1255537130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4455 E 12TH AVE",
"city": "DENVER",
"state": "CO",
"postal_code": "802202415",
"telephone_number": "303-504-7700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4455 E 12TH AVE",
"city": "DENVER",
"state": "CO",
"postal_code": "802202415",
"telephone_number": "303-504-7700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDE",
"first_name": "MEGHAN",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-26",
"last_updated": "2015-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "PSY0004167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.