Active NPI
James L Bludworth, PHD
- Psychologist
- Tempe, AZ
National Provider Identifier
1497908453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4000
- Practice address
- 1150 S Forest Ave # 334
Tempe, AZ 85287-0001 - Phone
- (480) 965-6147
- Fax
- (480) 965-3426
- NPI assigned
- Nov 3, 2008
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4000 | AZ | Primary |
Addresses
Primary practice location
1150 S Forest Ave # 334
Tempe, AZ 85287-0001
Mailing address
PO Box 5199
Abilene, TX 79608-5199
Phone (325) 437-8300
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4000 | AZ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arizona State University | Psychologist | 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": "1225670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225670400000",
"number": "1497908453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5199",
"city": "ABILENE",
"state": "TX",
"postal_code": "796085199",
"telephone_number": "325-437-8300",
"fax_number": "325-437-8390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1150 S FOREST AVE # 334",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852870001",
"telephone_number": "480-965-6147",
"fax_number": "480-965-3426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUDWORTH",
"first_name": "JAMES",
"middle_name": "L",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-11-03",
"last_updated": "2008-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AZ",
"license": "4000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.