Active NPI
John C Grisbacher, PSY D
- Psychologist
- East Petersburg, PA
National Provider Identifier
1619976677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS007811L
- Practice address
- 6079 Main St
East Petersburg, PA 17520-1267 - Phone
- (717) 560-1908
- Fax
- (717) 560-4941
- NPI assigned
- Jul 20, 2005
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS007811L | PA | Primary |
Addresses
Primary practice location
6079 Main St
East Petersburg, PA 17520-1267
Mailing address
200 North 7TH Street
Lebanon, PA 17046
Phone (717) 273-1710
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619976677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 NORTH 7TH STREET",
"city": "LEBANON",
"state": "PA",
"postal_code": "17046",
"telephone_number": "717-273-1710",
"fax_number": "717-273-1416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6079 MAIN ST",
"city": "EAST PETERSBURG",
"state": "PA",
"postal_code": "175201267",
"telephone_number": "717-560-1908",
"fax_number": "717-560-4941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRISBACHER",
"first_name": "JOHN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "PSY D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS007811L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Petersburg, PA
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.