Individual provider Active NPI

Robert Ingegneri, PSY.D.

  • Clinical Psychologist
  • Nevada, MO
National Provider Identifier
1053496042
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
01727 Issued in MO
Practice address
300 W Cherry St
Nevada, MO 64772-2202
Phone
(417) 667-4230
Fax
(417) 667-7607
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 01727 MO Primary

Addresses

Primary practice location

300 W Cherry St
Nevada, MO 64772-2202

Mailing address

300 W Cherry St
Nevada, MO 64772-2202
Phone (417) 667-4230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040901000872 MO Practitioner - Clinical Psychologist 8527033588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

300 W Cherry St
Nevada, MO 64772-2202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01727MOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Company II CurrentSince Nov 10, 2012 Accepting new patients

Locations

300 W Cherry St
Nevada, MO 64772
Phone (417) 448-9437

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1053496042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W CHERRY ST",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647722202",
            "telephone_number": "417-667-4230",
            "fax_number": "417-667-7607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W CHERRY ST",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647722202",
            "telephone_number": "417-667-4230",
            "fax_number": "417-667-7607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGEGNERI",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "01727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nevada, MO

Sources for this page

Verify at the official NPI Registry.