Longmont Psychiatric Associates, P.C.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

LONGMONT PSYCHIATRIC ASSOCIATES, P.C.

Practice address

1380 Tulop St.
Suite P
Longmont, CO 80501

Phone

(303) 772-3644

Fax

(303) 772-0889

NPI assigned

Jul 29, 2008

Last updated

Jul 29, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Severance B Kelley, M.D

Title

President of the Corporation

Phone

(303) 772-3644

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217289600000",
    "number": "1487810529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 TULOP ST.",
            "address_2": "SUITE P",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "80501",
            "telephone_number": "303-772-3644",
            "fax_number": "303-772-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 TULOP ST.",
            "address_2": "SUITE P",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "80501",
            "telephone_number": "303-772-3644",
            "fax_number": "303-772-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGMONT PSYCHIATRIC ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-29",
        "last_updated": "2008-07-29",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "SEVERANCE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT OF THE CORPORATION",
        "authorized_official_telephone_number": "303-772-3644",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04171047",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Longmont, CO
• Providers in Longmont, CO by specialty
• Psychiatry Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; 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.