Individual provider Active NPI

David B. Tarr, PH. D., HSPP

  • Clinical Psychologist
  • Indianapolis, IN
National Provider Identifier
1093746604
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20010518 Issued in IN
Practice address
4401 Central Ave
Indianapolis, IN 46205-1822
Phone
(317) 923-2333
Fax
(317) 923-2367
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 20010518 IN Primary

Addresses

Primary practice location

4401 Central Ave
Indianapolis, IN 46205-1822

Mailing address

4401 Central Ave
Indianapolis, IN 46205-1822
Phone (317) 923-2333

Other identifiers 2

IdentifierTypeStateIssuer
000000275547OtherANTHEM PIN NUMBER
100172790MedicaidIN

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)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093746604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 CENTRAL AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051822",
            "telephone_number": "317-923-2333",
            "fax_number": "317-923-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 CENTRAL AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051822",
            "telephone_number": "317-923-2333",
            "fax_number": "317-923-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARR",
        "first_name": "DAVID",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "PH. D., HSPP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20010518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN NUMBER",
            "identifier": "000000275547",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100172790",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.