DR. MOSHE MARK DOUGLAS WEXLER (NPI# 1801858865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801858865 |
| Entity Type | Individual |
| Full Name | DR. MOSHE MARK DOUGLAS WEXLER |
| Other Name | DR. MARK D WEXLER |
| Credential | PH.D. |
| Practice Address |
110 W. Ent Ave. Bldg 725 21 Mdos/sgoh Pafb CO 80914 |
| Mailing Address |
586 Observatory Dr Colorado Springs CO 80904-3959 |
| Practice Telephone | 7196416275 |
| Practice Fax Number | 7195567399 |
| Mailing Telephone | 7196416275 |
| Mailing Fax Number | 7196330150 |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2012-06-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 1863 | CO | Behavioral Health & Social Service Providers |
| Street Address |
110 W. ENT AVE. BLDG 725 21 MDOS/SGOH |
| City | PAFB |
| State | CO |
| Zip Code | 80914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356897250 | Kym Littlefield Whitaker | Nurse Practitioner | 110 Ent Avenue, Peterson Afb, CA 80914 | 2016-08-30 |
| 1114322583 | Jessica Charmaine Johnson | Social Worker | 559 Vincent St, Bldg 959, Attn: 21 Omrs/sgow, Peterson Afb, CO 80914 | 2014-10-28 |
| 1306916267 | John Frank Drozd | Psychologist | 21st Medical Group, 559 Vincent Street, Peterson Afb, CO 80914 | 2006-11-08 |
| 1215902002 | William J Dickson | Dentist | Peterson Afb, Bld 950, Colorado Springs, CO 80914 | 2006-02-23 |
| 1740889773 | Brandon Dean Estes | Dental Hygienist | 1055 Stewart Ave, Bldg 2018, Apo, AA 80914 | 2020-10-21 |
| 1811378607 | Justin Henry Noble | Family Medicine | 559 Vincent St, Colorado Springs, CO 80914 | 2015-06-17 |
| 1225458789 | Brianna Mcmurray | Family Medicine | 559 Vincent St Bldg 959, Colorado Springs, CO 80914 | 2014-04-23 |
| 1720406796 | Beth D Achterhoff | Physical Therapist | 559 Vincent St Bldg 959, Peterson Afb, CO 80914 | 2014-04-07 |
| 1225310162 | Zachary Edward Bishop | Pharmacist | 559 Vincent St, Attn: 21 Mdss/sgsap, Peterson Afb, CO 80914 | 2011-09-16 |
| 1659603256 | Thomas Wescott Mahoney | Family Medicine | 559 Vincent St, 21 Mdos/sgof Attn: Family Health, Peterson Afb, CO 80914 | 2010-02-05 |
| Find all providers in zip 80914 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609485648 | Poudre Valley Medical Group, LLC | Clinical Neuropsychologist | 175 S Union Blvd Ste 240, Colorado Springs, CO 80910-3125 | 2020-07-27 |
| 1184102790 | Emily Claire Maxwell | Clinical Neuropsychologist | 10111 Inverness Main St Unit 417, Englewood, CO 80112-5727 | 2018-08-06 |
| 1356828776 | Samantha D Stein | Clinical Neuropsychologist | 50 S Steele St Ste 250, Denver, CO 80209-2802 | 2018-07-27 |
| 1255848321 | Jill Gitten Aloia | Clinical Neuropsychologist | 2501 Walnut St Ste 102, Boulder, CO 80302-5752 | 2018-01-10 |
| 1497265367 | Alicia Williams | Clinical Neuropsychologist | 400 S Mccaslin Blvd Ste 212, Superior, CO 80027-9701 | 2017-10-05 |
| 1689102568 | 2 Peaks Center for Neuro Psychology | Clinical Neuropsychologist | 2001 S Shields Street, Bldg A, Fort Collins, CO 80526-1827 | 2017-05-23 |
| 1487192076 | Icn Pllc | Clinical Neuropsychologist | 255 Canyon Blvd Ste 300-f, Boulder, CO 80302-4979 | 2017-02-03 |
| 1972048098 | Neurofeedback Colorado Springs, Inc. | Clinical Neuropsychologist | 2918 Beacon St Ste A, Colorado Springs, CO 80907-9208 | 2016-12-28 |
| 1720537467 | Zachary Sussman | Clinical Neuropsychologist | 2501 Walnut St Ste 104, Boulder, CO 80302-5752 | 2016-09-22 |
| 1053781401 | Valerie Sims | Clinical Neuropsychologist | 11705 Airport Way, Suite 301, Broomfield, CO 80021-2706 | 2015-09-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.