Ty Brumback, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P.08007 Issued in OH

Practice address

3380 Erie Ave Ste 202
Cincinnati, OH 45208-1626

Phone

(513) 400-5905

NPI assigned

Apr 9, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1316566474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7060 JEANNIE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452304031",
            "telephone_number": "859-572-1484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 ERIE AVE STE 202",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452081626",
            "telephone_number": "513-400-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMBACK",
        "first_name": "TY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-09",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "P.08007",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "P.08007",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "OH",
            "license": "P.08007",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "OH",
            "license": "P.08007",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "P.08007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Forrest Brugler, APRN-CNP
• Claudia Vanessa Bruguera Torres, M.D
• Tyler Jacob Bruinsma, MD
• Aimee Bruketa, ATC
• Terra Brulport
• Cheryl Shiverdecker Brumbaugh, C.N.P.
• Brittany M. M. Brumett
• Lakeisha Brumfield, REGISTER NURSE
• Marlena Brumfield
• Cortnee Brumley

• Clinical Psychologist in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; 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.