Organization Active NPI

J M Atwater, PHD

  • Clinical Psychologist
  • Palm Beach Gardens, FL
National Provider Identifier
1992164339
Registry record updated Feb 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY0003419 Issued in FL
Legal business name
J M ATWATER, PHD
Practice address
4362 Northlake Blvd
Suite 108
Palm Beach Gardens, FL 33410-6275
Phone
(561) 694-1887
Fax
(561) 626-2131
NPI assigned
Feb 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2016

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

Authorized official

Name
Dr. J M Atwater, PH.D.
Title
Owner
Phone
(561) 694-1887

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY0003419 FL Primary

Addresses

Primary practice location

4362 Northlake Blvd
Suite 108
Palm Beach Gardens, FL 33410-6275

Mailing address

4362 Northlake Blvd
Suite 108
Palm Beach Gardens, FL 33410-6275
Phone (561) 694-1887

National Provider Directory

National Provider Directory

Locations

4362 Northlake Blvd
Ste 108
Palm Beach Gardens, FL 33410
Phone (518) 581-8400

Practitioners & affiliated clinicians

Practitioners 1

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": "1455321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455321600000",
    "number": "1992164339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4362 NORTHLAKE BLVD",
            "address_2": "SUITE 108",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334106275",
            "telephone_number": "561-694-1887",
            "fax_number": "561-626-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4362 NORTHLAKE BLVD",
            "address_2": "SUITE 108",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334106275",
            "telephone_number": "561-694-1887",
            "fax_number": "561-626-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J M ATWATER, PHD",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-13",
        "last_updated": "2016-02-13",
        "status": "A",
        "authorized_official_last_name": "ATWATER",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-694-1887",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY0003419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.