Active NPI
Mary Zander, PH.D.
- Clinical Psychologist
- Kirtland AFB, NM
National Provider Identifier
1891181509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 613
- Practice address
- 2050A 2ND St SE
Kirtland AFB, NM 87117-5522 - Phone
- (520) 228-4357
- NPI assigned
- Apr 9, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 613 | WY | Primary |
Addresses
Primary practice location
2050A 2ND St SE
Kirtland AFB, NM 87117-5522
Mailing address
5427 E Madera St BLDG 4339
Davis-Monthan AFB, AZ 85708
Phone (520) 228-4357
Other names 1
- Mary Butler
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 613 | WY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680652800000",
"number": "1891181509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5427 E MADERA ST BLDG 4339",
"city": "DAVIS-MONTHAN AFB",
"state": "AZ",
"postal_code": "85708",
"telephone_number": "520-228-4357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2050A 2ND ST SE",
"city": "KIRTLAND AFB",
"state": "NM",
"postal_code": "871175522",
"telephone_number": "520-228-4357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZANDER",
"first_name": "MARY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-09",
"last_updated": "2023-04-05",
"certification_date": "2023-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WY",
"license": "613",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "BUTLER",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Kirtland AFB, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.