Active NPI
Christina A Pietz, PHD, LP
- Clinical Psychologist
- Springfield, MO
National Provider Identifier
1891791430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- R0275
- Practice address
- 1300 E Bradford Pkwy
Springfield, MO 65804-4264 - Phone
- (417) 269-5400
- Fax
- (417) 269-7212
- NPI assigned
- Jun 27, 2005
- 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 | R0275 | MO | Primary |
Addresses
Primary practice location
1300 E Bradford Pkwy
Springfield, MO 65804-4264
Mailing address
1300 E Bradford Pkwy
Springfield, MO 65804-4264
Phone (417) 269-5400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 499750917 | Medicaid | MO |
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0275 | MO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695340800000",
"number": "1891791430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 E BRADFORD PKWY",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658044264",
"telephone_number": "417-269-5400",
"fax_number": "417-269-7212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 E BRADFORD PKWY",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658044264",
"telephone_number": "417-269-5400",
"fax_number": "417-269-7212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIETZ",
"first_name": "CHRISTINA",
"middle_name": "A",
"credential": "PHD, LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-27",
"last_updated": "2023-09-22",
"certification_date": "2023-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "R0275",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "499750917",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.