NPIMap

Individual provider Active NPI

Judson Ryan Poling, PSYD

  • Clinical Psychologist
  • Lone Tree, CO
National Provider Identifier
1790289213
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY.0006202 Issued in CO
Practice address
9540 Park Meadows Dr
Lone Tree, CO 80124-2894
Phone
(720) 848-0000
Fax
(785) 452-4932
NPI assigned
Mar 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY.0006202 CO Primary
Clinical Psychologist 103TC0700X 2646 KS
Psychologist 103T00000X 2646 KS

Addresses

Primary practice location

9540 Park Meadows Dr
Lone Tree, CO 80124-2894

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240201003545 CO Practitioner - Clinical Psychologist 5294088597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

9540 Park Meadows Dr
Lone Tree, CO 80124-2894
Phone (720) 848-9300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2646KSMDPsychologist
PSY.0006202COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians Incorporated Current Accepting new patients
University Physicians, Incorporated CurrentSince Jan 1, 2024 Accepting new patients
Redwood Psychology, PLLC Clinical Current Accepting new patients
University Physicians Incorporated CurrentSince Jan 1, 2024 Accepting new patients
University Physicians Incorporated PastSince Dec 24, 2023 Accepting new patients

Locations

1300 S Potomac St
Ste 122
Aurora, CO 80012
Phone (303) 369-1600

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

5495 Arapahoe Ave
Boulder, CO 80303
Phone (303) 415-4515

7960 S University Blvd
Ste 101
Centennial, CO 80122
Phone (303) 788-3100

Dept 1061
Denver, CO 80256

3055 Roslyn St
Unit 100
Denver, CO 80238
Phone (720) 553-2695

7400 E Crestline Cir
Ste 100
Greenwood Village, CO 80111
Phone (303) 770-4227

8080 Park Meadows Dr
Ste 100
Lone Tree, CO 80124
Phone (303) 346-8828

9540 Park Meadows Dr
Lone Tree, CO 80124
Phone (720) 516-9014

361 Centennial Pkwy
Ste 120
Louisville, CO 80027
Phone (303) 465-2323

7403 Church Ranch Blvd
Unit 107
Westminster, CO 80021
Phone (720) 848-9000

Organizations & group practices 5

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.

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1790289213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9540 PARK MEADOWS DR",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801242894",
            "telephone_number": "720-848-0000",
            "fax_number": "785-452-4932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLING",
        "first_name": "JUDSON",
        "middle_name": "RYAN",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-20",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0006202",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "2646",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "2646",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lone Tree, CO

Sources for this page

Verify at the official NPI Registry.