Organization Active NPI

Alancatkinsonphdpsychologistpc

  • Clinical Psychologist
  • Williamsville, NY
National Provider Identifier
1972547792
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7523-1 Issued in NY
Legal business name
ALANCATKINSONPHDPSYCHOLOGISTPC
Practice address
5784 Main St
Williamsville, NY 14221-5702
Phone
(716) 633-6863
Fax
(716) 633-9106
NPI assigned
Jun 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Alan C Atkinson, PH.D.NPI 1730122391
Title
President
Phone
(716) 633-6863

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 7523-1 NY Primary

Addresses

Primary practice location

5784 Main St
Williamsville, NY 14221-5702

Mailing address

5784 Main St
Williamsville, NY 14221-5702
Phone (716) 633-6863

Other identifiers 1

IdentifierTypeStateIssuer
00020550102OtherNYUNIVERA PROVIDER #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060323000489 NY Part B Supplier - Clinic/Group Practice 8123036753 Receives reassigned benefits from 1 practitioner
Practice locations: Buffalo, NY; Williamsville, NY

National Provider Directory

National Provider Directory

Locations

5784 Main St
Williamsville, NY 14221
Phone (716) 633-6863

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972547792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5784 MAIN ST",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215702",
            "telephone_number": "716-633-6863",
            "fax_number": "716-633-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5784 MAIN ST",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215702",
            "telephone_number": "716-633-6863",
            "fax_number": "716-633-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALANCATKINSONPHDPSYCHOLOGISTPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ATKINSON",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-633-6863",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "7523-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA PROVIDER #",
            "identifier": "00020550102",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.