John Charles Geddes, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PSY-005529 Issued in AZ

Practice address

3611 Crossings Dr Ste a
Prescott, AZ 86305-7181

Phone

(604) 791-0983

NPI assigned

May 15, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Chuck Geddes Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1366133092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 DEERFIELD RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863035359",
            "telephone_number": "604-791-0983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 CROSSINGS DR STE A",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057181",
            "telephone_number": "604-791-0983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEDDES",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "AZ",
            "license": "PSY-005529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHUCK",
            "last_name": "GEDDES",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Maria Sylvia Garcia, P.T.
• Allen Richard Gardner, MD
• Andrew S Garff, MD
• Cody Gawlitta
• Suzanne Gaynor, L.AC.
• Steve Jerome Gehl, DC
• Geiler and Geiler, PLLC
• Thomas G Geiler, O.D.
• Todd G. Geiler, O.D.
• Mitchell L Gelber, ED.D.

• Clinical Child & Adolescent Psychologist in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Clinical Child & Adolescent Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.