Individual provider Active NPI

John Frank Drozd, PHD

  • Clinical Psychologist
  • Peterson AFB, CO
National Provider Identifier
1306916267
Registry record updated Jul 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2529 Issued in CO
Practice address
21St Medical Group
559 Vincent Street
Peterson AFB, CO 80914
Phone
(719) 556-7804
NPI assigned
Nov 8, 2006
Last updated
Jul 12, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2018

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 2529 CO Primary

Addresses

Primary practice location

21St Medical Group
559 Vincent Street
Peterson AFB, CO 80914

Mailing address

21St Medical Group
559 Vincent Street
Peterson AFB, CO 80914
Phone (719) 556-7804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120118000721 CO Practitioner - Clinical Psychologist 8628245487 Reassigns benefits to 3 organizations
I20250729001892 WA Practitioner - Clinical Psychologist 8628245487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
State University of New York at Stony Brook, School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctor on Demand Professionals P CGroup PAC ID 9436464567, 113 clinicians
Mind Spa PCGroup PAC ID 9032507926, 5 clinicians

Practice addresses (Care Compare)

300 Deschutes Way SW
Suite 208
Tumwater, WA 98501-7719
Phone (800) 997-6196

5340 S Quebec St
Suite 230S
Greenwood Village, CO 80111-1909
Phone (720) 766-9831

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2529COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Doctor on Demand Professionals P C CurrentSince Oct 1, 2023 Accepting new patients
Mind Spa Inc CurrentSince Dec 28, 2024 Accepting new patients
Premise Health of Colorado Medical PC CurrentSince Feb 18, 2020 Accepting new patients
Boston Thermography Center Inc. Current Accepting new patients
Premise Health of Colorado Medical PC CurrentSince Feb 18, 2020 Accepting new patients
Iron Will Holdings, LLC PastSince Dec 28, 2024 Accepting new patients
The Neuroassessment Centre, LLC Past Accepting new patients

Locations

1 California St
Ste 2300
San Francisco, CA 94111
Phone (800) 929-0926

275 Battery St
Ste 650
San Francisco, CA 94111
Phone 4155043838104

1675 Garden of the Gods Rd
Ste 1053
Colorado Springs, CO 80907
Phone (719) 520-7601

5340 S Quebec St
Ste 230S
Greenwood Village, CO 80111
Phone (720) 766-9831

1900 W Littleton Blvd
Littleton, CO 80120
Phone 41550438389238

5500 Maryland Way
Ste 120
Brentwood, TN 37027

300 Deschutes Way SW
Ste 208
Tumwater, WA 98501
Phone (617) 249-6854

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EJHECD/Endpoint/EJHECD
  • Direct secure messaging: john.drozd.1@30520.direct.athenahealth.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1306916267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21ST MEDICAL GROUP",
            "address_2": "559 VINCENT STREET",
            "city": "PETERSON AFB",
            "state": "CO",
            "postal_code": "80914",
            "telephone_number": "719-556-7804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21ST MEDICAL GROUP",
            "address_2": "559 VINCENT STREET",
            "city": "PETERSON AFB",
            "state": "CO",
            "postal_code": "80914",
            "telephone_number": "719-556-7804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DROZD",
        "first_name": "JOHN",
        "middle_name": "FRANK",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "2529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peterson AFB, CO

Sources for this page

Verify at the official NPI Registry.