Active NPI
John K Fitzgibbons, LCP
- Clinical Psychologist
- Westminster, CO
National Provider Identifier
1396861902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1175
- Practice address
- 7701 Sheridan Blvd
Westminster, CO 80003-2605 - Phone
- (303) 338-4545
- NPI assigned
- Mar 22, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1175 | CO | Primary |
Addresses
Primary practice location
7701 Sheridan Blvd
Westminster, CO 80003-2605
Mailing address
7701 Sheridan Blvd
Westminster, CO 80003-2605
Phone (303) 338-4545
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008179 | Other | CO | KAISER PROVIDER NUMBER |
| 07011752 | Medicaid | CO |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1175 | CO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302220800000",
"number": "1396861902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7701 SHERIDAN BLVD",
"city": "WESTMINSTER",
"state": "CO",
"postal_code": "800032605",
"telephone_number": "303-338-4545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7701 SHERIDAN BLVD",
"city": "WESTMINSTER",
"state": "CO",
"postal_code": "800032605",
"telephone_number": "303-338-4545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGIBBONS",
"first_name": "JOHN",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "LCP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-22",
"last_updated": "2011-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "1175",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER PROVIDER NUMBER",
"identifier": "008179",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07011752",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Westminster, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.