Active NPI
Paul Manfred Spengler, PH.D., HSPP
- Psychologist
- Muncie, IN
National Provider Identifier
1275684508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 20040707A
- Practice address
- 1945 W Royale Dr
Muncie, IN 47304-2265 - Phone
- (765) 288-7939
- Fax
- (765) 288-7841
- NPI assigned
- Jan 15, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 20040707A | IN | Primary |
Addresses
Primary practice location
1945 W Royale Dr
Muncie, IN 47304-2265
Mailing address
1945 W Royale Dr
Muncie, IN 47304-2265
Phone (765) 288-7939
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000330991 | Other | IN | BLUE CROSS BLUE SHIELD |
| 100333770B | Medicaid | IN |
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: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2018 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amh, Inc | Past | 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": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275684508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1945 W ROYALE DR",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473042265",
"telephone_number": "765-288-7939",
"fax_number": "765-288-7841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1945 W ROYALE DR",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473042265",
"telephone_number": "765-288-7939",
"fax_number": "765-288-7841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPENGLER",
"first_name": "PAUL",
"middle_name": "MANFRED",
"credential": "PH.D., HSPP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IN",
"license": "20040707A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "000000330991",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100333770B",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muncie, IN
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.