John R Bigelow Jr., PSYD
Individual provider Active NPI Clinical Psychologist · Atlantic, IA
NPI 1912978586 · NPPES record last updated Jan 10, 2017
Key facts
- NPI
- 1912978586
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 00889 (IA)
- Practice address
- 1500 E 10TH St
Atlantic, IA 50022 - Phone
- (712) 243-2606
- Fax
- (712) 243-2688
- NPI assigned
- Jan 31, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2022 through Apr 1, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00889 | IA | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kavalier & Associates PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 00889 | IA | Yes |
Addresses
Primary practice location
1500 E 10TH St
Atlantic, IA 50022
Mailing address
1500 E 10TH St
Atlantic, IA 50022
Phone (712) 243-2606
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0008938 | Medicaid | IA |
Other providers in Atlantic, IA
- Taylor Beane
- Suzanne M Beitzel
- Cassie J Berens
- Janet Sue Bergman
- Elaine K. Berry
- Tamara Bireline
- Bloom Behavioral Health LLC
- Body Basics Chiropractic, PC
- Joshua Borer
- Celeste L Borts
All providers in Atlantic, IA · Clinical Psychologist in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.