Individual provider Active NPI

Steven L. Ater, PSY.D.

  • Clinical Neuropsychologist
  • Pocatello, ID
National Provider Identifier
1902906209
Registry record updated Aug 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
5525037-2501 Issued in UT
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, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2009

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
PSY-202491IDMDPsychologist
5525037-2501UTMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.