Active NPI
Kevin W Popp, PSYD
- Clinical Psychologist
- Washington, DC
National Provider Identifier
1518020163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY1831
- Practice address
- 5100 Wisconsin Ave NW Ste 300
Washington, DC 20016-4130 - Phone
- (202) 244-8855
- Fax
- (202) 244-8856
- NPI assigned
- Dec 18, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY1831 | DC | Primary |
Addresses
Primary practice location
5100 Wisconsin Ave NW Ste 300
Washington, DC 20016-4130
Mailing address
3315 Legation St NW
Washington, DC 20015-1711
Phone (202) 441-3555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 14, 2025 through Feb 14, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY1831 | DC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1518020163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3315 LEGATION ST NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200151711",
"telephone_number": "202-441-3555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5100 WISCONSIN AVE NW STE 300",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200164130",
"telephone_number": "202-244-8855",
"fax_number": "202-244-8856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POPP",
"first_name": "KEVIN",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "DC",
"license": "PSY1831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.