Individual provider Active NPI

Justin Hull Ory, PH.D.

  • Clinical Neuropsychologist
  • Moore, OK
National Provider Identifier
1124426671
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
1334 Issued in OK
Practice address
1044 SW 4TH St
Moore, OK 73160-2405
Phone
(405) 735-6300
NPI assigned
Dec 16, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Neuropsychologist 103G00000X 1334 OK Primary

Addresses

Primary practice location

1044 SW 4TH St
Moore, OK 73160-2405

Mailing address

1044 SW 4TH St
Moore, OK 73160-2405
Phone (405) 735-6300

Other identifiers 1

IdentifierTypeStateIssuer
1334OtherOKOKLAHOMA HSP LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20190820000135 OK Practitioner - Clinical Psychologist 0648508358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moore Counseling Center, P.C.Group PAC ID 9436151511, 5 clinicians

Practice addresses (Care Compare)

1044 SW 4TH St
Moore, OK 73160-2405
Phone (405) 735-6333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Moore Counseling Center, P.C. CurrentSince Jul 10, 2019 Accepting new patients

Locations

1044 SW 4th St
Moore, OK 73160
Phone (405) 735-6333

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": "1418688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1124426671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 SW 4TH ST",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602405",
            "telephone_number": "405-735-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 SW 4TH ST",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602405",
            "telephone_number": "405-735-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORY",
        "first_name": "JUSTIN",
        "middle_name": "HULL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-16",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "OK",
            "license": "1334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA HSP LICENSE",
            "identifier": "1334",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, OK

Sources for this page

Verify at the official NPI Registry.