Active NPI
Philip D Sutton, PH.D.
- Psychologist
- Boulder, CO
National Provider Identifier
1376561555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 817
- Practice address
- 595 Canyon Blvd
Boulder, CO 80302-5029 - Phone
- (303) 258-7582
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 817 | CO | Primary |
Addresses
Primary practice location
595 Canyon Blvd
Boulder, CO 80302-5029
Mailing address
PO Box 1781
Nederland, CO 80466-1781
Phone (303) 258-7582
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 817 | CO | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brian T. Shea DO LLC | Past | Accepting new patients | |
| The Boulder Hospice | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Boulder, CO
- NPI 1235327198
-
- Community Based Hospice Care Agency
- Boulder, CO
- NPI 1831629237
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376561555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1781",
"city": "NEDERLAND",
"state": "CO",
"postal_code": "804661781",
"telephone_number": "303-258-7582",
"fax_number": "303-444-7371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "595 CANYON BLVD",
"city": "BOULDER",
"state": "CO",
"postal_code": "803025029",
"telephone_number": "303-258-7582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTTON",
"first_name": "PHILIP",
"middle_name": "D",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CO",
"license": "817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.