Individual provider Active NPI

John L. Santa, PH.D.

  • Clinical Psychologist
  • Marion, MT
National Provider Identifier
1336320134
Registry record updated Nov 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
195 Issued in MT
Practice address
9705 Lost Prairie Rd
Marion, MT 59925-9844
Phone
(406) 858-2339
Fax
(406) 858-2356
NPI assigned
Nov 20, 2007
Last updated
Nov 20, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2007

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 195 MT Primary

Addresses

Primary practice location

9705 Lost Prairie Rd
Marion, MT 59925-9844

Mailing address

9705 Lost Prairie Rd
Marion, MT 59925-9844
Phone (406) 858-2339

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
195MTMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195516800000",
    "number": "1336320134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9705 LOST PRAIRIE RD",
            "city": "MARION",
            "state": "MT",
            "postal_code": "599259844",
            "telephone_number": "406-858-2339",
            "fax_number": "406-858-2356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9705 LOST PRAIRIE RD",
            "city": "MARION",
            "state": "MT",
            "postal_code": "599259844",
            "telephone_number": "406-858-2339",
            "fax_number": "406-858-2356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTA",
        "first_name": "JOHN",
        "middle_name": "L.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-20",
        "last_updated": "2007-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MT",
            "license": "195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; 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.