Active NPI
Ronald David Kingsley, PH.D.
- Psychologist
- Mesa, AZ
National Provider Identifier
1700987633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1441
- Practice address
- 1150 N Countryclub Dr #10
10
Mesa, AZ 85201 - Phone
- (480) 962-8883
- Fax
- (480) 962-4308
- NPI assigned
- Sep 25, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1441 | AZ | Primary |
Addresses
Primary practice location
1150 N Countryclub Dr #10
10
Mesa, AZ 85201
Mailing address
3502 E Dragoon Ave
Mesa, AZ 85204-4032
Phone (480) 924-1548
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 |
|---|---|---|---|
| 1441 | AZ | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700987633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3502 E DRAGOON AVE",
"city": "MESA",
"state": "AZ",
"postal_code": "852044032",
"telephone_number": "480-924-1548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1150 N COUNTRYCLUB DR #10",
"address_2": "10",
"city": "MESA",
"state": "AZ",
"postal_code": "85201",
"telephone_number": "480-962-8883",
"fax_number": "480-962-4308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINGSLEY",
"first_name": "RONALD",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AZ",
"license": "1441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
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.