Individual provider Active NPI

William J Sturtevant, PHD

  • Clinical Psychologist
  • Brownsburg, IN
National Provider Identifier
1902841455
Registry record updated Nov 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20040306A Issued in IN
Practice address
2 East Tilden
Brownsburg, IN 46112-1648
Phone
(317) 852-8585
NPI assigned
Jun 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20040306A IN Primary

Addresses

Primary practice location

2 East Tilden
Brownsburg, IN 46112-1648

Mailing address

5310 Ward Road
Suite 106
Arvada, CO 80002-1829
Phone (303) 278-7418

Other identifiers 3

IdentifierTypeStateIssuer
000000232186OtherINANTHEM
20224870AMedicaidIN
680010869OtherINRAILROAD

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

LicenseStateTypeSpecialty
20040306AINMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1902841455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 WARD ROAD",
            "address_2": "SUITE 106",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800021829",
            "telephone_number": "303-278-7418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EAST TILDEN",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461121648",
            "telephone_number": "317-852-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURTEVANT",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20040306A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000232186",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20224870A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "680010869",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsburg, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.