Individual provider Active NPI

Norman I Itkowitz, PSY.D.

  • Clinical Psychologist
  • Memphis, TN
National Provider Identifier
1760599799
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1004 Issued in LA
Practice address
5685 Vantage PT
Memphis, TN 38120
Phone
(901) 517-5460
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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 1004 LA Primary

Addresses

Primary practice location

5685 Vantage PT
Memphis, TN 38120

Mailing address

5685 Vantage PT
Memphis, TN 38120-2539
Phone (901) 517-5460

Other practice location 1

1030 Jefferson Ave
Memphis, TN 38104-2127
Phone (901) 523-9000

Other practice location 2

1030 Jefferson Ave
Memphis, TN 38104-2127
Phone (901) 523-9000

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

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1760599799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5685 VANTAGE PT",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202539",
            "telephone_number": "901-517-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5685 VANTAGE PT",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38120",
            "telephone_number": "901-517-5460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1030 Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381042127",
            "country_code": "US",
            "telephone_number": "901-523-9000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1030 Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381042127",
            "country_code": "US",
            "telephone_number": "901-523-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ITKOWITZ",
        "first_name": "NORMAN",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "LA",
            "license": "1004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.