Individual provider Active NPI

Joanne Citron Burgio, PH.D.

  • Clinical Psychologist
  • Meridian, ID
National Provider Identifier
1396852083
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY203093 Issued in ID
Practice address
943 W Overland Rd
Meridian, ID 83642-6541
Phone
(208) 519-9102
Fax
(208) 550-3483
NPI assigned
Aug 25, 2006
Last updated
Mar 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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 PSY203093 ID Primary

Addresses

Primary practice location

943 W Overland Rd
Meridian, ID 83642-6541

Mailing address

943 W Overland Rd
Meridian, ID 83642-6541
Phone (208) 519-9102

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

LicenseStateTypeSpecialty
PSY203093IDMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Joanne Burgio PHD LLC CurrentSince Dec 1, 2020 Accepting new patients

Locations

3061 S Meridian Rd
Ste 150
Meridian, ID 83642
Phone (208) 631-5063

943 W Overland Rd
Meridian, ID 83642
Phone (208) 850-1476

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1396852083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 W OVERLAND RD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426541",
            "telephone_number": "208-519-9102",
            "fax_number": "208-550-3483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "943 W OVERLAND RD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426541",
            "telephone_number": "208-519-9102",
            "fax_number": "208-550-3483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGIO",
        "first_name": "JOANNE",
        "middle_name": "CITRON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ID",
            "license": "PSY203093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.