John L Gustavson, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY.0000987 Issued in CO

Practice address

2530 N 8TH St
Suite 204
Grand Junction, CO 81501-8857

Phone

(970) 245-3505

NPI assigned

Jan 20, 2006

Last updated

Oct 30, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psychological Associates of Western Co. P.C.Group PAC ID 2567594294, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Psychological Associates of Western Co. P.C.

  • Clinical Neuropsychologist
  • Grand Junction, CO
  • NPI 1033233176
  Medicare reassignment Care Compare group NPD
• Lower Valley Hospital Association

  dba FHW Physician Services

  • Anesthesiology Physician
  • Fruita, CO
  • NPI 1609190206
  Medicare reassignment NPD
• Lower Valley Hospital Association

  dba Family Health West

  • Critical Access Hospital
  • Fruita, CO
  • NPI 1861496697
  Medicare reassignment NPD
• Lower Valley Hospital Association

  dba Family Health West Primary Care

  • Family Medicine Physician
  • Grand Junction, CO
  • NPI 1194323832
  NPD
• Lower Valley Hospital Association

  dba Family Health West Endocrinology

  • Endocrinology, Diabetes & Metabolism Physician
  • Fruita, CO
  • NPI 1346095098
  NPD
• Lower Valley Hospital Association

  dba Family Health West Behavioral Health

  • Clinical Psychologist
  • Fruita, CO
  • NPI 1386071991
  NPD (past)

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1720068059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 N 8TH ST",
            "address_2": "SUITE 204",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018857",
            "telephone_number": "970-245-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 N 8TH ST",
            "address_2": "SUITE 204",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018857",
            "telephone_number": "970-245-3505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 W Ottley Ave",
            "address_purpose": "LOCATION",
            "city": "Fruita",
            "state": "CO",
            "postal_code": "815212118",
            "country_code": "US",
            "telephone_number": "970-858-2527",
            "fax_number": "970-858-8684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUSTAVSON",
        "first_name": "JOHN",
        "middle_name": "L",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CO",
            "license": "PSY.0000987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07987001",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alan Guerrie, DDS
• Amy Guion, LPN
• Craig Allen Gustafson, MD
• Amy Gustavson
• Eric John Gustavson, MS, LPC
• Lisa Elaine Gustin
• Nicoleena Marie Guthro, R.PH
• Alicia Gutierrez, LSW
• Diana Gutierrez, MA, LPC
• Fabiola Marisol Gutierrez

• Clinical Neuropsychologist in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Clinical Neuropsychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.