DR. DOMINIC RICHARD PRIME PHD
NPI 1972027852
Psychologist in Sherwood, OR

Active since August 01, 2017PECOS Enrolled
16770 SW EDY RD STE 102, SHERWOOD, OR 97140(503) 216-9600 Get Directions Write a Review

NPPES record last updated: December 29, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 29, 2021, Apr 5, 2021, Apr 9, 2019 and 1 more (4 updates tracked since 2017).

About Dr. Dominic Richard Prime Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DOMINIC RICHARD PRIME PHD (NPI 1972027852) is an individual psychologist in Sherwood, Oregon, licensed in California (30305) and active in the NPI registry since August 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1972027852
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. DOMINIC RICHARD PRIMECredential: PHD
Location Address16770 SW EDY RD STE 102Sherwood, OR 97140-9679
Mailing Address1800 Harrison St Fl 7Oakland, CA 94612-3466 · (510) 625-2856 · Fax (877) 738-4262
Sole ProprietorNo
Enumeration DateAugust 1, 2017
Last NPPES UpdateDecember 29, 20214 updates tracked since enumeration
NPPES CertifiedApril 5, 2021
NPI 1972027852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Licenses Licensed in CA · 30305 Licensed in OR · 3023
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
16770 SW EDY RD STE 102, Sherwood, OR 97140

Other Identifiers 1

Medicaid500758548OR

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Dominic Richard Prime Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
16770 SW EDY RD STE 102
SHERWOOD, OR 97140
Physician Assistant
16770 SW EDY RD STE 102
SHERWOOD, OR 97140
Psychologist (Clinical)
16770 SW EDY RD STE 102
SHERWOOD, OR 97140
Dietitian, Registered
16770 SW EDY RD STE 102
SHERWOOD, OR 97140
Nurse Practitioner (Family)
16770 SW EDY RD STE 102
SHERWOOD, OR 97140
Physician Assistant
16770 SW EDY RD STE 102
SHERWOOD, OR 97140
Family Medicine
16770 SW EDY RD STE 102
SHERWOOD, OR 97140
Physician Assistant
16770 SW EDY RD STE 102
SHERWOOD, OR 97140

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dominic Prime's NPI number?

The NPI number for Dominic Prime is 1972027852. It was assigned to this individual provider in the NPPES registry on August 1, 2017.

Where is Dominic Prime located?

Dominic Prime practices at 16770 SW Edy Rd Ste 102, Sherwood, OR 97140. The listed phone number is (503) 216-9600.

What is Dominic Prime's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Dominic Prime enrolled in Medicare?

Yes. Dominic Prime is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Dominic Prime was last updated on December 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.