Active NPI
Mark A Whisman, PHD
- Clinical Psychologist
- Boulder, CO
National Provider Identifier
1649643503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY.0002802
- Practice address
- Muenzinger D319
Boulder, CO 80309-0345 - Phone
- (303) 492-8569
- NPI assigned
- Nov 1, 2015
- Last updated
- Nov 1, 2015
- 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 Psychologist | 103TC0700X | PSY.0002802 | CO | Primary |
Addresses
Primary practice location
Muenzinger D319
Boulder, CO 80309-0345
Mailing address
345 Ucb
Boulder, CO 80309-0345
Phone (303) 492-8569
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY.0002802 | CO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446336000000",
"number": "1649643503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 UCB",
"city": "BOULDER",
"state": "CO",
"postal_code": "803090345",
"telephone_number": "303-492-8569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MUENZINGER D319",
"city": "BOULDER",
"state": "CO",
"postal_code": "803090345",
"telephone_number": "303-492-8569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHISMAN",
"first_name": "MARK",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-11-01",
"last_updated": "2015-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "PSY.0002802",
"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 Nov 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.