Individual provider Active NPI

Christopher David Schmelzle, PH.D.

  • Clinical Psychologist
  • Flagstaff, AZ
National Provider Identifier
1740509884
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY005422 Issued in AZ
Practice address
2202 N Old Stump Way
Flagstaff, AZ 86004-7623
Phone
(619) 455-8689
Fax
(619) 330-9676
NPI assigned
May 28, 2010
Last updated
Feb 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY31560 CA
Clinical Psychologist 103TC0700X PSY005422 AZ Primary

Addresses

Primary practice location

2202 N Old Stump Way
Flagstaff, AZ 86004-7623

Mailing address

2532 N 4TH St # 584
Flagstaff, AZ 86004-3712
Phone (619) 455-8689

Other practice location 1

1350 Columbia St Unit 402
San Diego, CA 92101-3455
Phone (619) 455-8689

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220422002026 AZ Practitioner - Clinical Psychologist 5698162774 Reassigns benefits to 1 organization
I20250114004071 CA Practitioner - Clinical Psychologist 5698162774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2202 N Old Stump Way
Flagstaff, AZ 86004-7623
Phone (619) 455-8689

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY005422AZMDClinical Psychologist
PSY31560CAMDClinical Psychologist
31560CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Blaess, PH.D., Psychologist, Inc. Clinical CurrentSince Nov 6, 2024 Accepting new patients
Christopher Schmelzle PHD Psychologist Inc CurrentSince Sep 28, 2021 Accepting new patients
Southwest Psychology LLC Clinical PastSince Jan 29, 2023 Accepting new patients

Locations

2532 N 4th St
Flagstaff, AZ 86004
Phone (928) 226-1563

1350 Columbia St
Unit 402
San Diego, CA 92101
Phone (619) 393-1447

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1275004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1740509884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2532 N 4TH ST # 584",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860043712",
            "telephone_number": "619-455-8689",
            "fax_number": "619-330-9676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 N OLD STUMP WAY",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860047623",
            "telephone_number": "619-455-8689",
            "fax_number": "619-330-9676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 Columbia St Unit 402",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921013455",
            "country_code": "US",
            "telephone_number": "619-455-8689",
            "fax_number": "619-436-5765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHMELZLE",
        "first_name": "CHRISTOPHER",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-28",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY31560",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "PSY005422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.