Individual provider Active NPI

Emily D. Richardson, PH.D.

  • Clinical Neuropsychologist
  • Boulder, CO
National Provider Identifier
1316024110
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
2351 Issued in CO
Practice address
345 Ucb
Muenzinger D232A
Boulder, CO 80309-0345
Phone
(303) 735-1130
Fax
(303) 492-2967
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2351 CO
Clinical Psychologist 103TC0700X 2351 CO
Clinical Neuropsychologist 103G00000X 2351 CO Primary

Addresses

Primary practice location

345 Ucb
Muenzinger D232A
Boulder, CO 80309-0345

Mailing address

2200 Creekside Drive
Longmont, CO 80504-7795
Phone (303) 735-1130

Other practice location 1

6897 Paiute Ave
Niwot, CO 80503-7182
Phone (303) 735-1130

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
I20040107000489 CO Practitioner - Clinical Psychologist 9335048537 Practice locations: Niwot, CO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6897 Paiute Ave
Suite 2a
Niwot, CO 80503-7169
Phone (720) 505-3260

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2351COMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1316024110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 CREEKSIDE DRIVE",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805047795",
            "telephone_number": "303-735-1130",
            "fax_number": "303-492-2967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 UCB",
            "address_2": "MUENZINGER D232A",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803090345",
            "telephone_number": "303-735-1130",
            "fax_number": "303-492-2967"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6897 Paiute Ave",
            "address_purpose": "LOCATION",
            "city": "Niwot",
            "state": "CO",
            "postal_code": "805037182",
            "country_code": "US",
            "telephone_number": "303-735-1130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "EMILY",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "2351",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "2351",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CO",
            "license": "2351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.