Individual provider Active NPI

James R Corcoran, PHD

  • Clinical Psychologist
  • Fort Collins, CO
National Provider Identifier
1720289176
Registry record updated Feb 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
CO1498 Issued in CO
Practice address
2001 South Shields Building L
Fort Collins, CO 80526-1839
Phone
(970) 416-8626
Fax
(970) 493-6643
NPI assigned
May 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X CO1498 CO Primary

Addresses

Primary practice location

2001 South Shields Building L
Fort Collins, CO 80526-1839

Mailing address

2001 South Shields Building L
Fort Collins, CO 80526-1839
Phone (970) 416-8626

Other identifiers 1

IdentifierTypeStateIssuer
07014988MedicaidCO

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110818000560 CO Practitioner - Clinical Psychologist 7719157205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4025 St Cloud Dr
Suite 200
Loveland, CO 80538-9311
Phone (970) 416-8626

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
CO1498COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Health Psychology Consultants Clinical CurrentSince Jan 18, 1991 Accepting new patients

Locations

2001 S Shields St
Ste L
Fort Collins, CO 80526
Phone (970) 221-0565

1030 Centre Ave
#B
Fort Collins, CO 80526
Phone (970) 416-8626

4025 St Cloud Dr
Ste 200
Loveland, CO 80538
Phone (970) 416-8626

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203638400000",
    "number": "1720289176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 SOUTH SHIELDS BUILDING L",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805261839",
            "telephone_number": "970-416-8626",
            "fax_number": "970-493-6643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SOUTH SHIELDS BUILDING L",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805261839",
            "telephone_number": "970-416-8626",
            "fax_number": "970-493-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORCORAN",
        "first_name": "JAMES",
        "middle_name": "R",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2008-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "CO1498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07014988",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.