Active NPI
Steven L. Ater, PSY.D.
- Clinical Neuropsychologist
- Pocatello, ID
National Provider Identifier
1902906209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 5525037-2501
- Practice address
- 500 S. 11TH St.
Portneuf Medical Center
Pocatello, ID 83201 - Phone
- (435) 828-8028
- NPI assigned
- Sep 25, 2006
- Last updated
- Aug 20, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 5525037-2501 | UT | Primary |
| Clinical Neuropsychologist | 103G00000X | PSY-202491 | ID | |
| Psychologist | 103T00000X | 5525037-2501 | UT | |
| Psychologist | 103T00000X | PSY-202491 | ID | |
| Clinical Psychologist | 103TC0700X | 5525037-2501 | UT | |
| Clinical Psychologist | 103TC0700X | PSY-202491 | ID | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 5525037-2501 | UT | |
| Family Psychologist | 103TF0000X | PSY-202491 | ID |
Addresses
Primary practice location
500 S. 11TH St.
Portneuf Medical Center
Pocatello, ID 83201
Mailing address
500 S. 11TH St.
Portneuf Medical Center Behavioral Health
Pocatello, ID 83201
Phone (435) 828-8028
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2021 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY-202491 | ID | MD | Psychologist |
| 5525037-2501 | UT | MD | Clinical Child & Adolescent Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jeff Henderson PHD Psychological Services and Consulting PC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Counseling Psychologist
- Prescott, AZ
- NPI 1255413118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250726400000",
"number": "1902906209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 S. 11TH ST.",
"address_2": "PORTNEUF MEDICAL CENTER BEHAVIORAL HEALTH",
"city": "POCATELLO",
"state": "ID",
"postal_code": "83201",
"telephone_number": "435-828-8028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 S. 11TH ST.",
"address_2": "PORTNEUF MEDICAL CENTER",
"city": "POCATELLO",
"state": "ID",
"postal_code": "83201",
"telephone_number": "435-828-8028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATER",
"first_name": "STEVEN",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2009-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "UT",
"license": "5525037-2501",
"primary": true
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "ID",
"license": "PSY-202491",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "UT",
"license": "5525037-2501",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "ID",
"license": "PSY-202491",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "UT",
"license": "5525037-2501",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "ID",
"license": "PSY-202491",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "UT",
"license": "5525037-2501",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "ID",
"license": "PSY-202491",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pocatello, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.