Active NPI
Derek Francisco Munoz, PSY.D.
- Clinical Psychologist
- Fort Carson, CO
National Provider Identifier
1538204615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3057
- Practice address
- 7490 Sutherland Circle
Ft. Carson, CO 80913-4613 - Phone
- (719) 526-5815
- NPI assigned
- Feb 20, 2007
- 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 | 3057 | CO | Primary |
Addresses
Primary practice location
7490 Sutherland Circle
Ft. Carson, CO 80913-4613
Mailing address
1650 Cochrane Cir
Ft Carson, CO 80913-4613
Phone (719) 526-5815
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3057 | CO | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722297600000",
"number": "1538204615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 COCHRANE CIR",
"city": "FT CARSON",
"state": "CO",
"postal_code": "809134613",
"telephone_number": "719-526-5815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7490 SUTHERLAND CIRCLE",
"city": "FT. CARSON",
"state": "CO",
"postal_code": "809134613",
"telephone_number": "719-526-5815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNOZ",
"first_name": "DEREK",
"middle_name": "FRANCISCO",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-20",
"last_updated": "2024-07-30",
"certification_date": "2024-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "3057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Carson, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.