Active NPI
John Halvorson, PHD
- Clinical Psychologist
- Grand Junction, CO
National Provider Identifier
1780660670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 511
- Practice address
- 1160 Patterson Rd
Grand Junction, CO 81506-8275 - Phone
- (970) 244-2800
- Fax
- (970) 255-6291
- NPI assigned
- Dec 21, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 511 | CO | Primary |
Addresses
Primary practice location
1160 Patterson Rd
Grand Junction, CO 81506-8275
Mailing address
PO Box 62
Grand Junction, CO 81502-0062
Phone (970) 244-2894
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07005119 | Medicaid | CO |
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 |
|---|---|---|---|
| 511 | CO | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Mary's Hospital and Medical Center, Inc | Past | Accepting new patients |
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.
-
- Hematology & Oncology Physician
- Grand Junction, CO
- NPI 1275714081
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195516800000",
"number": "1780660670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 62",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815020062",
"telephone_number": "970-244-2894",
"fax_number": "970-255-1809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1160 PATTERSON RD",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815068275",
"telephone_number": "970-244-2800",
"fax_number": "970-255-6291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALVORSON",
"first_name": "JOHN",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-21",
"last_updated": "2007-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "511",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07005119",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Junction, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.