Individual provider Active NPI

Thomas J Harbin, PH.D.

  • Psychologist
  • Fayetteville, NC
National Provider Identifier
1154393395
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1530 Issued in NC
Practice address
2411 Robeson St
Suite 200
Fayetteville, NC 28305-5549
Phone
(910) 609-1990
Fax
(910) 609-1993
NPI assigned
Feb 2, 2006
Last updated
Dec 1, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 1530 NC
Psychologist 103T00000X 1530 NC Primary

Addresses

Primary practice location

2411 Robeson St
Suite 200
Fayetteville, NC 28305-5549

Mailing address

2411 Robeson St
Suite 200
Fayetteville, NC 28305-5549
Phone (910) 609-1990

Other identifiers 5

IdentifierTypeStateIssuer
6138588OtherNCUBH
0334AOtherNCBCBSNC -- INDIVIDUAL
175921OtherNCCOMPSYCH
6000311MedicaidNC
015J8OtherNCBCBSNC -- GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1530NCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Harbin and Assoicates Clinical Neuropsychologist PastSince Jul 1, 1990 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1154393395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 ROBESON ST",
            "address_2": "SUITE 200",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055549",
            "telephone_number": "910-609-1990",
            "fax_number": "910-609-1993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 ROBESON ST",
            "address_2": "SUITE 200",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055549",
            "telephone_number": "910-609-1990",
            "fax_number": "910-609-1993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARBIN",
        "first_name": "THOMAS",
        "middle_name": "J",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NC",
            "license": "1530",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "1530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "6138588",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC -- INDIVIDUAL",
            "identifier": "0334A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "175921",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000311",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC -- GROUP",
            "identifier": "015J8",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.