Individual provider Active NPI

Boyd Randal Horton, PSY D, HSPP

  • Clinical Psychologist
  • Indianapolis, IN
National Provider Identifier
1376827915
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20041741A Issued in IN
Practice address
1800 N Meridian St Ste 202
Indianapolis, IN 46202-1443
Phone
(317) 981-5503
NPI assigned
Sep 30, 2011
Last updated
Jun 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X
Clinical Psychologist 103TC0700X 20041741A IN Primary
Intellectual & Developmental Disabilities Psychologist 103TM1800X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

1800 N Meridian St Ste 202
Indianapolis, IN 46202-1443

Mailing address

8946 Forest Willow Dr
Indianapolis, IN 46234-8903
Phone (317) 374-5183

Other practice location 1

8946 Forest Willow Dr
Indianapolis, IN 46234-8903
Phone (317) 374-5183

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040304000103 IN Practitioner - Clinical Psychologist 9638066517 Reassigns benefits to 1 organization
I20220222000903 MI Practitioner - Clinical Psychologist 9638066517 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Evolutis, LLC Addiction (Substance Use Disorder) CurrentSince Jan 3, 2022 Accepting new patients
Greenhouse and Associates Inc. Clinical Past Accepting new patients
Conduct Curb, LLC Past Accepting new patients
Psychological Laboratories of Indianapolis, PC Past Accepting new patients

Locations

1650 45th St
Ste 3
Munster, IN 46321
Phone (219) 220-2021

2222 W Grand River Ave
Ste A
Okemos, MI 48864
Phone (734) 602-4635

Organizations & group practices 4

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": "1317340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1376827915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8946 FOREST WILLOW DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462348903",
            "telephone_number": "317-374-5183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N MERIDIAN ST STE 202",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021443",
            "telephone_number": "317-981-5503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8946 Forest Willow Dr",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462348903",
            "country_code": "US",
            "telephone_number": "317-374-5183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORTON",
        "first_name": "BOYD",
        "middle_name": "RANDAL",
        "name_prefix": "Mr.",
        "credential": "PSY D, HSPP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-30",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041741A",
            "primary": true
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.