Mark Anthony Prince, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY.0004925 Issued in CO

Practice address

1876 Campus Delivery # Clarkc07
Fort Collins, CO 80523-1876

Phone

(619) 994-1518

NPI assigned

Dec 2, 2018

Last updated

Dec 2, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Usc Care Medical Group, Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1902846306
  Medicare reassignment NPD
• Usc Care Medical Group, Inc

  dba Fair Oaks Clinic

  • Durable Medical Equipment & Medical Supplies
  • Pasadena, CA
  • NPI 1427937390
  NPD

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

{
    "created_epoch": "1543708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543708800000",
    "number": "1487124517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3203 SNOWBRUSH PL",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805217549",
            "telephone_number": "619-994-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1876 CAMPUS DELIVERY # CLARKC07",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805231876",
            "telephone_number": "619-994-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-02",
        "last_updated": "2018-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0004925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Vane Price, L.C.S.W.
• Philip N. Priebe, M.D.
• Jennifer Kim Pries, LCSW
• Kaeden Rose Primavera, NREMT
• Jean-Christophe P Prin, L.AC
• Mary Prince, ATC
• Sripriya Madura Prince, DPT
• Jordan Prindle, CPO
• Prism Counseling PLLC
• Ciera Pritchard

• Clinical Psychologist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.