Active NPI
Michael Marcy, PHD
- Psychologist
- Appleton, WI
National Provider Identifier
1114945136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 859-057
- Practice address
- VA Outpatient Clinic
Appleton, WI 54914 - Phone
- (920) 831-7900
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 859-057 | WI | Primary |
| Psychologist | 103T00000X | 6301008295 | MI |
Addresses
Primary practice location
VA Outpatient Clinic
Appleton, WI 54914
Mailing address
N3594 Sunset LN
New London, WI 54961-8846
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6301008295 | MI | MD | Psychologist |
| 859-057 | WI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114945136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N3594 SUNSET LN",
"city": "NEW LONDON",
"state": "WI",
"postal_code": "549618846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "VA OUTPATIENT CLINIC",
"city": "APPLETON",
"state": "WI",
"postal_code": "54914",
"telephone_number": "920-831-7900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCY",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WI",
"license": "859-057",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301008295",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Appleton, WI
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.