NPIMap

Organization Active NPI

High Plains Neuropsychology Associates PC

  • Clinical Neuropsychologist
  • Las Vegas, NM
National Provider Identifier
1780916130
Registry record updated Mar 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
761 Issued in NM
Legal business name
HIGH PLAINS NEUROPSYCHOLOGY ASSOCIATES PC
Practice address
1101 Douglas Ave
Las Vegas, NM 87701-3932
Phone
(505) 429-4679
NPI assigned
Feb 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2011

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

Authorized official

Name
Dr. Gerald Russell
Title
Clinical Neuropsychologist
Phone
(505) 429-4679

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X 761 NM Primary

Addresses

Primary practice location

1101 Douglas Ave
Las Vegas, NM 87701-3932

Mailing address

PO Box 1705
Las Vegas, NM 87701-1705

National Provider Directory

National Provider Directory

Locations

1101 Douglas Ave
Las Vegas, NM 87701
Phone (505) 429-4679

NPI Registry JSON

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

{
    "created_epoch": "1265760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299801600000",
    "number": "1780916130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1705",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877011705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 DOUGLAS AVE",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877013932",
            "telephone_number": "505-429-4679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGH PLAINS NEUROPSYCHOLOGY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-10",
        "last_updated": "2011-03-11",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "CLINICAL NEUROPSYCHOLOGIST",
        "authorized_official_telephone_number": "505-429-4679",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "NM",
            "license": "761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2011; 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.