Active NPI
Lisa A Boyum, PH.D.
- Psychologist
- Denver, CO
National Provider Identifier
1508955600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1975
- Practice address
- 2121 S Oneida St Ste 336
Denver, CO 80224-2552 - Phone
- (303) 718-1503
- NPI assigned
- Oct 12, 2006
- Sex
- Female
- 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 | 1975 | CO | Primary |
Addresses
Primary practice location
2121 S Oneida St Ste 336
Denver, CO 80224-2552
Mailing address
2047 S Milwaukee St Apt 5
Denver, CO 80210-3553
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BOB54745 | Other | CO | ECT PROVIDER ID |
| 11238397 | Other | CO | CAQH PROVIDER ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141215001785 | CO | Practitioner - Clinical Psychologist | 1850613241 | Practice locations: Denver, CO; Centennial, CO |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1975 | CO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508955600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2047 S MILWAUKEE ST APT 5",
"city": "DENVER",
"state": "CO",
"postal_code": "802103553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2121 S ONEIDA ST STE 336",
"city": "DENVER",
"state": "CO",
"postal_code": "802242552",
"telephone_number": "303-718-1503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYUM",
"first_name": "LISA",
"middle_name": "A",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CO",
"license": "1975",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ECT PROVIDER ID",
"identifier": "BOB54745",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH PROVIDER ID",
"identifier": "11238397",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.