Individual provider Active NPI

Donna Frances Degeorge, PHD

  • Psychologist
  • Northglenn, CO
National Provider Identifier
1487729836
Registry record updated Apr 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1617 Issued in CO
Practice address
11154 Huron St
Suite 211
Northglenn, CO 80234-2328
Phone
(303) 888-2120
Fax
(303) 255-2567
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1617 CO Primary

Addresses

Primary practice location

11154 Huron St
Suite 211
Northglenn, CO 80234-2328

Mailing address

12725 Home Farm Dr
Westminster, CO 80234-1778
Phone (303) 888-2120

Other identifiers 1

IdentifierTypeStateIssuer
07016173MedicaidCO

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
1617COMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Connections of Texas, PLLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272499200000",
    "number": "1487729836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12725 HOME FARM DR",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802341778",
            "telephone_number": "303-888-2120",
            "fax_number": "303-255-2567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11154 HURON ST",
            "address_2": "SUITE 211",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802342328",
            "telephone_number": "303-888-2120",
            "fax_number": "303-255-2567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGEORGE",
        "first_name": "DONNA",
        "middle_name": "FRANCES",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2010-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "1617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07016173",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northglenn, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2010; 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.