Individual provider Active NPI

Betsy L Gilpin, PHD

  • Psychologist
  • Phoenix, AZ
National Provider Identifier
1902955065
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PHD975 Issued in AZ
Practice address
1133 E Missouri Ave
Suite M
Phoenix, AZ 85014-2788
Phone
(602) 234-0870
Fax
(602) 274-3422
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PHD975 AZ Primary

Addresses

Primary practice location

1133 E Missouri Ave
Suite M
Phoenix, AZ 85014-2788

Mailing address

1133 E Missouri Ave
Suite M
Phoenix, AZ 85014-2788
Phone (602) 234-0870

Other identifiers 2

IdentifierTypeStateIssuer
043215OtherAZMHN #
AZ0609390OtherAZBCBS #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20050927001385 AZ Practitioner - Clinical Psychologist 7113952391 Practice locations: Phoenix, AZ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1133 E Missouri Ave
Suite M
Phoenix, AZ 85014-2789

1133 E Missouri M
Phoenix, AZ 85014-2789
Phone (602) 234-0870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PHD975AZMDPsychologist
975AZMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1902955065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 E MISSOURI AVE",
            "address_2": "SUITE M",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142788",
            "telephone_number": "602-234-0870",
            "fax_number": "602-274-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 E MISSOURI AVE",
            "address_2": "SUITE M",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142788",
            "telephone_number": "602-234-0870",
            "fax_number": "602-274-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILPIN",
        "first_name": "BETSY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "PHD975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN #",
            "identifier": "043215",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS #",
            "identifier": "AZ0609390",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.