Active NPI
Mark Carter, PHD
- Clinical Psychologist
- Cotopaxi, CO
National Provider Identifier
1457697336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2866
- Practice address
- 48 Grouse Run Rd
Cotopaxi, CO 81223-0423 - Phone
- (719) 942-3664
- NPI assigned
- Dec 20, 2012
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2866 | CO | Primary |
Addresses
Primary practice location
48 Grouse Run Rd
Cotopaxi, CO 81223-0423
Mailing address
PO Box 423
48 Grouse Run Rd
Cotopaxi, CO 81223-0423
Phone (719) 942-3664
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 |
|---|---|---|---|
| 2866 | CO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452470400000",
"number": "1457697336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 423",
"address_2": "48 GROUSE RUN RD",
"city": "COTOPAXI",
"state": "CO",
"postal_code": "812230423",
"telephone_number": "719-942-3664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48 GROUSE RUN RD",
"city": "COTOPAXI",
"state": "CO",
"postal_code": "812230423",
"telephone_number": "719-942-3664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTER",
"first_name": "MARK",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-12-20",
"last_updated": "2016-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "2866",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cotopaxi, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.