Active NPI
Justin Kohlhagen
- Psychologist
- Sunrise, FL
National Provider Identifier
1790140374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 5100 Nob Hill Rd
Sunrise, FL 33351 - Phone
- (954) 315-8697
- NPI assigned
- Dec 23, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary | ||
| School Psychologist | 103TS0200X |
Addresses
Primary practice location
5100 Nob Hill Rd
Sunrise, FL 33351
Mailing address
5100 Nob Hill Rd
Sunrise, FL 33351
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": "1450828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450915200000",
"number": "1790140374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5100 NOB HILL RD",
"city": "SUNRISE",
"state": "FL",
"postal_code": "33351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5100 NOB HILL RD",
"city": "SUNRISE",
"state": "FL",
"postal_code": "33351",
"telephone_number": "954-315-8697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHLHAGEN",
"first_name": "JUSTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-12-23",
"last_updated": "2015-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunrise, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.