Active NPI
Gift Wahiwe McDougal, MA
- Clinical Psychologist
- Aurora, CO
National Provider Identifier
1811264724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0004288
- Practice address
- 11059 E Bethany Dr
Suite 200
Aurora, CO 80014-2622 - Phone
- (303) 627-2009
- Fax
- (303) 617-2397
- NPI assigned
- Nov 20, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | 0004288 | CO | Primary |
Addresses
Primary practice location
11059 E Bethany Dr
Suite 200
Aurora, CO 80014-2622
Mailing address
11059 E Bethany Dr
Suite 200
Aurora, CO 80014-2622
Phone (303) 627-2009
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) | Permanente Medical Group |
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)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0004288 | CO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641772800000",
"number": "1811264724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11059 E BETHANY DR",
"address_2": "SUITE 200",
"city": "AURORA",
"state": "CO",
"postal_code": "800142622",
"telephone_number": "303-627-2009",
"fax_number": "303-617-2397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11059 E BETHANY DR",
"address_2": "SUITE 200",
"city": "AURORA",
"state": "CO",
"postal_code": "800142622",
"telephone_number": "303-627-2009",
"fax_number": "303-617-2397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDOUGAL",
"first_name": "GIFT",
"middle_name": "WAHIWE",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-20",
"last_updated": "2022-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "0004288",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "2400 Mount Zion Pkwy",
"city": "Jonesboro",
"state": "GA",
"country_code": "US",
"postal_code": "302362500",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.