Raymond E Gornell, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2621 Issued in CO

Practice address

1815 65TH Ave
#2
Greeley, CO 80634-7964

Phone

(970) 518-8809

Fax

(303) 691-0763

NPI assigned

Aug 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Colorado Visiting Nurse AssociationGroup PAC ID 3173617883, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northwest Colorado Visiting Nurse Association

  • Community Health Clinic/Center
  • Craig, CO
  • NPI 1073693677
  Medicare reassignment Care Compare group NPD
• Northwest Colorado Visiting Nurse Association

  • Skilled Nursing Facility
  • Steamboat Springs, CO
  • NPI 1316764517
  NPD

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256860800000",
    "number": "1902914344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2696 S COLORADO BLVD",
            "address_2": "SUITE 308",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802225945",
            "telephone_number": "970-518-8809",
            "fax_number": "303-691-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 65TH AVE",
            "address_2": "#2",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806347964",
            "telephone_number": "970-518-8809",
            "fax_number": "303-691-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORNELL",
        "first_name": "RAYMOND",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-27",
        "last_updated": "2009-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NE",
            "license": "637",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "2621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriel McKenna Goodman, LCSW
• Mikayla Goodman
• Jody A. Goodwine, MA, LPC
• Marlene Gordo-Luna
• Julia Gormley, RD
• Daniel James Goss, O.T.
• Troy Josef Gottlieb, DO
• Amber Graber, M.S., CCC-SLP
• Zachary Aaron Graber, DPT, CSCS
• Grace Elizabeth Grady

• Clinical Psychologist in Greeley, CO
• Providers in Greeley, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.