Individual provider Active NPI

Ralph Edwin Landefeld, PH.D.

  • Psychologist
  • Meadville, PA
National Provider Identifier
1073557138
Registry record updated Oct 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS002990-L Issued in PA
Practice address
10159 Nancy Dr
Meadville, PA 16335-6323
Phone
(724) 601-4901
Fax
(814) 336-5388
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS002990-L PA Primary

Addresses

Primary practice location

10159 Nancy Dr
Meadville, PA 16335-6323

Mailing address

10159 Nancy Dr
Meadville, PA 16335-6323
Phone (724) 601-4901

Other identifiers 1

IdentifierTypeStateIssuer
0146700MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS002990-LPAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychology & Learning Center Inc Past Accepting new patients
Ralph E. Landefeld PH.D. P.C. Psychologist Past Accepting new patients
Psychology and Learning Center Past Accepting new patients

Organizations & group practices 3

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1073557138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10159 NANCY DR",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163356323",
            "telephone_number": "724-601-4901",
            "fax_number": "814-336-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10159 NANCY DR",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163356323",
            "telephone_number": "724-601-4901",
            "fax_number": "814-336-5388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDEFELD",
        "first_name": "RALPH",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS002990-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0146700",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meadville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; 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.