Active NPI
James I Kepner, PHD
- Psychologist
- Beachwood, OH
National Provider Identifier
1295863736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3379
- Practice address
- 21403 Chagrin Blvd
Ste 210
Beachwood, OH 44122-5322 - Phone
- (216) 283-0736
- NPI assigned
- Feb 28, 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 | 3379 | OH | Primary |
Addresses
Primary practice location
21403 Chagrin Blvd
Ste 210
Beachwood, OH 44122-5322
Mailing address
21403 Chagrin Blvd
Ste 210
Beachwood, OH 44122-5322
Phone (216) 283-0736
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081103000421 | OH | Practitioner - Clinical Psychologist | 6800955006 | Practice locations: Cleveland, OH |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
21403 Chagrin Blvd
Suite 210
Beachwood, OH 44122-5322
3372 Clayton Blvd
Cleveland, OH 44120-3342
Phone (440) 473-8973
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3379 | OH | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295863736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21403 CHAGRIN BLVD",
"address_2": "STE 210",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441225322",
"telephone_number": "216-283-0736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21403 CHAGRIN BLVD",
"address_2": "STE 210",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441225322",
"telephone_number": "216-283-0736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEPNER",
"first_name": "JAMES",
"middle_name": "I",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "3379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beachwood, OH
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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.