Individual provider Active NPI

Cara Aileen Misetic, PSY.D.

  • Clinical Psychologist
  • Greenwood, IN
National Provider Identifier
1154512101
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20042131A Issued in IN
Practice address
494 S Emerson Ave
Suite D
Greenwood, IN 46143-1912
Phone
(317) 889-3901
Fax
(317) 889-3902
NPI assigned
Aug 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 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 20042131A IN Primary

Addresses

Primary practice location

494 S Emerson Ave
Suite D
Greenwood, IN 46143-1912

Mailing address

494 S Emerson Ave
Suite D
Greenwood, IN 46143-1912
Phone (317) 889-3901

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

State licenses

LicenseStateTypeSpecialty
20042131AINMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Institute for Neuropsychology & Behavioral Health Clinical PastSince Jan 1, 2005 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": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1154512101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "494 S EMERSON AVE",
            "address_2": "SUITE D",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431912",
            "telephone_number": "317-889-3901",
            "fax_number": "317-889-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "494 S EMERSON AVE",
            "address_2": "SUITE D",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431912",
            "telephone_number": "317-889-3901",
            "fax_number": "317-889-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISETIC",
        "first_name": "CARA",
        "middle_name": "AILEEN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042131A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.