Active NPI
Gregory G Bishop, PH.D.
- Clinical Child & Adolescent Psychologist
- Tigard, OR
National Provider Identifier
1639298771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 961
- Practice address
- 7505 SW Beveland Rd
Suite 102
Tigard, OR 97223-8682 - Phone
- (503) 670-7410
- Fax
- (503) 670-1066
- NPI assigned
- Mar 28, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 Child & Adolescent Psychologist | 103TC2200X | 961 | OR | Primary |
Addresses
Primary practice location
7505 SW Beveland Rd
Suite 102
Tigard, OR 97223-8682
Mailing address
7505 SW Beveland Rd
Suite 102
Tigard, OR 97223-8682
Phone (503) 670-7410
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 15, 2024 through Mar 15, 2028
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": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639298771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7505 SW BEVELAND RD",
"address_2": "SUITE 102",
"city": "TIGARD",
"state": "OR",
"postal_code": "972238682",
"telephone_number": "503-670-7410",
"fax_number": "503-670-1066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7505 SW BEVELAND RD",
"address_2": "SUITE 102",
"city": "TIGARD",
"state": "OR",
"postal_code": "972238682",
"telephone_number": "503-670-7410",
"fax_number": "503-670-1066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BISHOP",
"first_name": "GREGORY",
"middle_name": "G",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "OR",
"license": "961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tigard, OR
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.