Individual provider Active NPI

Peter Endyke, PSYD

  • Clinical Psychologist
  • Spokane, WA
National Provider Identifier
1508821042
Registry record updated Apr 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY00002511 Issued in WA
Practice address
7307 N Division St
Suite 311
Spokane, WA 99208-6545
Phone
(509) 464-0300
Fax
(509) 468-2479
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY00002511 WA Primary

Addresses

Primary practice location

7307 N Division St
Suite 311
Spokane, WA 99208-6545

Mailing address

7307 N Division St
Suite 311
Spokane, WA 99208-6545
Phone (509) 464-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20060116000440 WA Practitioner - Clinical Psychologist 4082638267 Practice locations: Spokane, WA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7307 N Division St
Suite 311
Spokane, WA 99208-6554
Phone (509) 464-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1508821042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7307 N DIVISION ST",
            "address_2": "SUITE 311",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992086545",
            "telephone_number": "509-464-0300",
            "fax_number": "509-468-2479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7307 N DIVISION ST",
            "address_2": "SUITE 311",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992086545",
            "telephone_number": "509-464-0300",
            "fax_number": "509-468-2479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDYKE",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00002511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.