Individual provider Active NPI

David J Ogren, PH.D.

  • Clinical Psychologist
  • Fitchburg, WI
National Provider Identifier
1598812653
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2680-057 Issued in WI
Practice address
2916 Marketplace Dr
Ste 212
Fitchburg, WI 53719-5325
Phone
(608) 609-6709
Fax
(608) 238-3159
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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 2680-057 WI Primary

Addresses

Primary practice location

2916 Marketplace Dr
Ste 212
Fitchburg, WI 53719-5325

Mailing address

2840 Osmundsen Rd
Fitchburg, WI 53711-5138
Phone (608) 609-6709

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2680-057WIMDClinical Psychologist
21332TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1598812653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 OSMUNDSEN RD",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537115138",
            "telephone_number": "608-609-6709",
            "fax_number": "608-238-3159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2916 MARKETPLACE DR",
            "address_2": "STE 212",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537195325",
            "telephone_number": "608-609-6709",
            "fax_number": "608-238-3159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGREN",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2680-057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.