Individual provider Active NPI

Tamar R Kelson, PH.D.

  • Psychologist
  • Madison, WI
National Provider Identifier
1104981604
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1806-057 Issued in WI
Practice address
702 N. Blackhawk Ave.
Suite 209
Madison, WI 53715
Phone
(608) 204-9116
Fax
(608) 441-3370
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1806-057 WI Primary

Addresses

Primary practice location

702 N. Blackhawk Ave.
Suite 209
Madison, WI 53715

Mailing address

702 N. Blackhawk Ave
Suite 209
Madison, WI 53715
Phone (608) 204-9116

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
1806-057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Emily Barr Ruth, PSYD, LLC Past Accepting new patients

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": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259798400000",
    "number": "1104981604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 N. BLACKHAWK AVE",
            "address_2": "SUITE 209",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53715",
            "telephone_number": "608-204-9116",
            "fax_number": "608-441-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 N. BLACKHAWK AVE.",
            "address_2": "SUITE 209",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53715",
            "telephone_number": "608-204-9116",
            "fax_number": "608-441-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSON",
        "first_name": "TAMAR",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2009-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1806-057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; 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.