Active NPI
Grant N Newbold, PSY.D.
- Clinical Psychologist
- Kearney, NE
National Provider Identifier
1962511881
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 582
- Practice address
- 904 E 25TH St
Kearney, NE 68847-4603 - Phone
- (308) 830-3070
- NPI assigned
- Aug 30, 2006
- Last updated
- Aug 21, 2014
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 582 | NE | Primary |
Addresses
Primary practice location
904 E 25TH St
Kearney, NE 68847-4603
Mailing address
1650 32 Rd
Minden, NE 68959-6612
Phone (308) 830-3070
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 |
|---|---|---|---|
| 582 | NE | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bond Enterprises Inc | 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.
-
dba Willowbrook Centre
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Kearney, NE
- NPI 1790826147
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408579200000",
"number": "1962511881",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 32 RD",
"city": "MINDEN",
"state": "NE",
"postal_code": "689596612",
"telephone_number": "308-830-3070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "904 E 25TH ST",
"city": "KEARNEY",
"state": "NE",
"postal_code": "688474603",
"telephone_number": "308-830-3070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWBOLD",
"first_name": "GRANT",
"middle_name": "N",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2014-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NE",
"license": "582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.