Individual provider Active NPI

Joan M Unruh

  • Psychologist
  • Boulder, CO
National Provider Identifier
1649396276
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2708 Issued in CO
Practice address
737 29TH St
Suite 200
Boulder, CO 80303-2317
Phone
(303) 668-9024
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2708 CO Primary

Addresses

Primary practice location

737 29TH St
Suite 200
Boulder, CO 80303-2317

Mailing address

1561 Bain Dr
Erie, CO 80516-7220
Phone (303) 828-2878

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

LicenseStateTypeSpecialty
2708COMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649396276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1561 BAIN DR",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805167220",
            "telephone_number": "303-828-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 29TH ST",
            "address_2": "SUITE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032317",
            "telephone_number": "303-668-9024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNRUH",
        "first_name": "JOAN",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "2708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

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.

Verify at the official NPI Registry.