Individual provider Active NPI

Michael Angelo Borders, PSY.D., ABPP, FAACP

Clinical Psychologist
Cochise, AZ

National Provider Identifier

1275696924

Registry record updated Dec 31, 2008

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
Organizations & group practices1
NPI Registry JSON
Other providers in Cochise, AZ
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Clinical PsychologistTaxonomy code 103TC0700X
License: 0810002999 Issued in VA
Practice address: 3300 N Mesquite Rd
Cochise, AZ 85606-8729
Phone: (520) 826-0299
Fax: (520) 826-0300
NPI assigned: Dec 17, 2006
Last updated: Dec 31, 2008By the provider in NPPES
Sex: Male
Sole proprietor: No

NPPES NPI Registry

Updated by the provider on Dec 31, 2008

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

Specialties & licenses 15

Specialty (taxonomy)	Code	License	State	Primary
Clinical Neuropsychologist	103G00000X	3861	AZ
Addiction (Substance Use Disorder) Psychologist	103TA0400X	0810002999	VA
Adult Development & Aging Psychologist	103TA0700X	0810002999	VA
Clinical Psychologist	103TC0700X	0810002999	VA	Primary
Exercise & Sports Psychologist	103TE1100X	3861	AZ
Family Psychologist	103TF0000X	0810002999	VA
Forensic Psychologist	103TF0200X	0810002999	VA
Health Service Psychologist	103TH0100X	0810002999	VA
Health Service Psychologist	103TH0100X	3861	AZ
Group Psychotherapy Psychologist	103TP2701X	0810002999	VA
Rehabilitation Psychologist	103TR0400X	3861	AZ
Rehabilitation Psychologist	103TR0400X	0810002999	VA
Contractor	171W00000X	3861	AZ
Military Health Care Provider	171000000X	3861	AZ
Health Psychologist	103TH0004X	3861	AZ

Addresses

Primary practice location

3300 N Mesquite Rd
Cochise, AZ 85606-8729

Mailing address

3300 N Mesquite Rd
Cochise, AZ 85606-8729
Phone (520) 826-0299

Other identifiers 5

Identifier	Type	State	Issuer
3861	Other	AZ	CLINICAL PSYCHOLOGY
5302	Other		AMERICAN BOARD OF PROFESS
8264	Other		AMERICAN COLLEGE OF FOREN
0810002999	Other	VA	CLINICAL PSYCHOLOGY
44572	Other		NATIONAL REGISTER OF HEAL

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Not enrolled

State licenses

License	State	Type	Specialty
0810002999	VA	MD	Health Service Psychologist
3861	AZ	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Growth Process Integration, Incorporated	Clinical Neuropsychologist	Past	Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Growth Process Integration, Incorporated
- Clinical Psychologist
- Cochise, AZ
- NPI 1144466707
Clinical Neuropsychologist
NPD (past) Authorized official

NPI Registry JSON

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

{
    "created_epoch": "1166313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230681600000",
    "number": "1275696924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 N MESQUITE RD",
            "city": "COCHISE",
            "state": "AZ",
            "postal_code": "856068729",
            "telephone_number": "520-826-0299",
            "fax_number": "520-826-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 N MESQUITE RD",
            "city": "COCHISE",
            "state": "AZ",
            "postal_code": "856068729",
            "telephone_number": "520-826-0299",
            "fax_number": "520-826-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDERS",
        "first_name": "MICHAEL",
        "middle_name": "ANGELO",
        "name_prefix": "Dr.",
        "credential": "PSY.D., ABPP, FAACP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-17",
        "last_updated": "2008-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AZ",
            "license": "3861",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0810002999",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "VA",
            "license": "0810002999",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810002999",
            "primary": true
        },
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": "AZ",
            "license": "3861",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "VA",
            "license": "0810002999",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "VA",
            "license": "0810002999",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "VA",
            "license": "0810002999",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "AZ",
            "license": "3861",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "VA",
            "license": "0810002999",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "AZ",
            "license": "3861",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "VA",
            "license": "0810002999",
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "AZ",
            "license": "3861",
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "AZ",
            "license": "3861",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "AZ",
            "license": "3861",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL PSYCHOLOGY",
            "identifier": "3861",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN BOARD OF PROFESS",
            "identifier": "5302",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN COLLEGE OF FOREN",
            "identifier": "8264",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL PSYCHOLOGY",
            "identifier": "0810002999",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL REGISTER OF HEAL",
            "identifier": "44572",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cochise, AZ

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2008; 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.