Active NPI
Joseph Richard Dispenza, PH.D.
- Psychologist
- Mount Pleasant, SC
National Provider Identifier
1912965336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 539
- Practice address
- 1092 Johnnie Dodds Blvd
Ste. 1a
Mount Pleasant, SC 29464-6109 - Phone
- (843) 881-8805
- NPI assigned
- May 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 539 | SC | Primary |
Addresses
Primary practice location
1092 Johnnie Dodds Blvd
Ste. 1a
Mount Pleasant, SC 29464-6109
Mailing address
1111 Inlet Cove CT
Mount Pleasant, SC 29464-4214
Phone (843) 881-8805
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSO189 | Medicaid | SC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 539 | SC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912965336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 INLET COVE CT",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294644214",
"telephone_number": "843-881-8805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1092 JOHNNIE DODDS BLVD",
"address_2": "STE. 1A",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294646109",
"telephone_number": "843-881-8805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DISPENZA",
"first_name": "JOSEPH",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "SC",
"license": "539",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSO189",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Pleasant, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.