Active NPI
John B. Prosser, PHD
- Clinical Psychologist
- Grand Prairie, TX
National Provider Identifier
1578873923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 25453
- Practice address
- 1013 Lakecrest St
Grand Prairie, TX 75051-3446 - Phone
- (512) 782-3601
- NPI assigned
- Oct 19, 2010
- Last updated
- Jan 22, 2014
- 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 | 25453 | TX | Primary |
Addresses
Primary practice location
1013 Lakecrest St
Grand Prairie, TX 75051-3446
Mailing address
1013 Lakecrest St
Grand Prairie, TX 75051-3446
Phone (512) 782-3601
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390348800000",
"number": "1578873923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1013 LAKECREST ST",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750513446",
"telephone_number": "512-782-3601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1013 LAKECREST ST",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750513446",
"telephone_number": "512-782-3601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROSSER",
"first_name": "JOHN",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-19",
"last_updated": "2014-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "25453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.