Active NPI
Amie Hvizdak, PSY.D.
- Psychologist
- Salem, OR
National Provider Identifier
1396110995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2852
- Practice address
- 2600 Center St NE
Salem, OR 97301-2682 - Phone
- (503) 945-9840
- NPI assigned
- Dec 8, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 2852 | OR | Primary |
Addresses
Primary practice location
2600 Center St NE
Salem, OR 97301-2682
Mailing address
2600 Center St NE
Salem, OR 97301-2682
Phone (503) 945-9840
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Outagamie | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Appleton, WI
- NPI 1629138995
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573171200000",
"number": "1396110995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 CENTER ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973012682",
"telephone_number": "503-945-9840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 CENTER ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973012682",
"telephone_number": "503-945-9840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HVIZDAK",
"first_name": "AMIE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-08",
"last_updated": "2019-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OR",
"license": "2852",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.