Individual provider Active NPI

Doug Patrick Smith, PH.D.

  • Psychologist
  • Highlands Ranch, CO
National Provider Identifier
1861559932
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2512 Issued in CO
Practice address
9088 Ridgeline Blvd
Suite 106
Highlands Ranch, CO 80129-2383
Phone
(303) 246-7559
Fax
(303) 831-9530
NPI assigned
Jan 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2512 CO Primary

Addresses

Primary practice location

9088 Ridgeline Blvd
Suite 106
Highlands Ranch, CO 80129-2383

Mailing address

3638 Dinosaur St
Castle Rock, CO 80109-3627
Phone (303) 246-7559

Other identifiers 1

IdentifierTypeStateIssuer
21472238MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050414000579 CO Practitioner - Clinical Psychologist 1557308186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7940 S University Blvd
Centennial, CO 80122-5104
Phone (303) 246-7559

7940 S University Boulevard
Suite 220
Centennial, CO 80122-5104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2512COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Counseling Professionals, P.C. Psychologist CurrentSince Jul 1, 2005 Accepting new patients

Locations

7940 S University Blvd
Ste 220
Centennial, CO 80122
Phone (303) 246-7559

90 Madison St
Ste 404
Denver, CO 80206
Phone (303) 246-7559

9088 Ridgeline Blvd
Ste 106
Highlands Ranch, CO 80129
Phone (720) 344-0139

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.

NPI Registry JSON

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861559932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3638 DINOSAUR ST",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801093627",
            "telephone_number": "303-246-7559",
            "fax_number": "303-831-9530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9088 RIDGELINE BLVD",
            "address_2": "SUITE 106",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292383",
            "telephone_number": "303-246-7559",
            "fax_number": "303-831-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DOUG",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "2512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21472238",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highlands Ranch, CO

Sources for this page

Verify at the official NPI Registry.