Individual provider Active NPI

Donald Harry McIntire, PHD

  • Clinical Psychologist
  • Marion, OH
National Provider Identifier
1346334810
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4545 Issued in OH
Practice address
125 Executive Dr
Suite 201
Marion, OH 43302-6285
Phone
(740) 387-3087
Fax
(740) 382-5034
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 4545 OH Primary

Addresses

Primary practice location

125 Executive Dr
Suite 201
Marion, OH 43302-6285

Mailing address

125 Executive Dr
Ste 201
Marion, OH 43302-6302
Phone (419) 562-2000

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
I20120809000209 OH Practitioner - Clinical Psychologist 2163678095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4545OHMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Center Street Community Clinic, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: donald.mcintire.p1@direct.centerstreetclinic.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1346334810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 EXECUTIVE DR",
            "address_2": "STE 201",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026302",
            "telephone_number": "419-562-2000",
            "fax_number": "419-562-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 EXECUTIVE DR",
            "address_2": "SUITE 201",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026285",
            "telephone_number": "740-387-3087",
            "fax_number": "740-382-5034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTIRE",
        "first_name": "DONALD",
        "middle_name": "HARRY",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "4545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

Verify at the official NPI Registry.