Active NPI
John P. Dewitt, PSY.D. HSPP
- Clinical Psychologist
- Evansville, IN
National Provider Identifier
1316929722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 20040964A
- Practice address
- 4770 Covert Ave
Suite 201
Evansville, IN 47714-5663 - Phone
- (812) 428-6299
- NPI assigned
- Nov 19, 2005
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 20040964A | IN | Primary |
Addresses
Primary practice location
4770 Covert Ave
Suite 201
Evansville, IN 47714-5663
Mailing address
5233 Tarrytown Rd
Newburgh, IN 47630-2041
Phone (812) 428-6299
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200014390 | Medicaid | IN | |
| 000000039796 | Other | IN | ANTHEM INSURANCE CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- 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 |
|---|---|---|---|---|
| I20050308000560 | IN | Practitioner - Clinical Psychologist | 7517911084 | Practice locations: Evansville, IN |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4770 Covert Ave
Suite 201
Evansville, IN 47714-5663
Phone (812) 428-6299
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1066 | KY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724198400000",
"number": "1316929722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5233 TARRYTOWN RD",
"city": "NEWBURGH",
"state": "IN",
"postal_code": "476302041",
"telephone_number": "812-428-6299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4770 COVERT AVE",
"address_2": "SUITE 201",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477145663",
"telephone_number": "812-428-6299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEWITT",
"first_name": "JOHN",
"middle_name": "P.",
"name_prefix": "Dr.",
"credential": "PSY.D. HSPP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-19",
"last_updated": "2024-08-21",
"certification_date": "2024-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "20040964A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200014390",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM INSURANCE CO",
"identifier": "000000039796",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.