Individual provider Active NPI

Katherine Theresa Platoni, PSYD

  • Clinical Psychologist
  • Centerville, OH
National Provider Identifier
1174593552
Registry record updated Jun 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4020 Issued in OH
Practice address
50 South Main Street
Centerville, OH 45458-2362
Phone
(937) 321-4020
Fax
(937) 435-8950
NPI assigned
Jan 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1432 VA
Clinical Psychologist 103TC0700X 4020 OH Primary

Addresses

Primary practice location

50 South Main Street
Centerville, OH 45458-2362

Mailing address

50 South Main Street
Centerville, OH 45458-2362
Phone (937) 321-4020

Other identifiers 1

IdentifierTypeStateIssuer
087330MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040713000549 OH Practitioner - Clinical Psychologist 9739167966 Practice locations: Centerville, OH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

50 S Main St
Centerville, OH 45458-2362
Phone (937) 321-4020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1432VAMDClinical Psychologist
4020OHMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591315200000",
    "number": "1174593552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 SOUTH MAIN STREET",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454582362",
            "telephone_number": "937-321-4020",
            "fax_number": "937-435-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 SOUTH MAIN STREET",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454582362",
            "telephone_number": "937-321-4020",
            "fax_number": "937-435-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLATONI",
        "first_name": "KATHERINE",
        "middle_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "1432",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "4020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "087330",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

Verify at the official NPI Registry.