Eugene Pernell Jr., PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301005277 Issued in MI

Practice address

5031 Park Lake Road
Meridian Professional Psychological Consultants
East Lansing, MI 48823-3835

Phone

(517) 332-0811

Fax

(517) 332-4452

NPI assigned

Mar 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Clinical Psychologist

Education

Other, 1971

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Meridian Professional Psychological ConsultantsGroup PAC ID 5193880284, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Meridian Professional Psychological Consultants

  • Psychiatry Physician
  • East Lansing, MI
  • NPI 1225150139
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386764694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5031 PARK LAKE ROAD",
            "address_2": "MERIDIAN PROFESSIONAL PSYCHOLOGICAL CONSULTANTS",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488233835",
            "telephone_number": "517-332-0811",
            "fax_number": "517-332-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5031 PARK LAKE ROAD",
            "address_2": "MERIDIAN PROFESSIONAL PSYCHOLOGICAL CONSULTANTS",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488233835",
            "telephone_number": "517-332-0811",
            "fax_number": "517-332-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERNELL",
        "first_name": "EUGENE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301005277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Lynne Pell, RN, BSN
• Monica Kris Pelowski, DO, MPH
• Ronald B. Penfield, MSW
• Elizabeth Ana Peralta, LMSW
• Richelle Elana Perkins
• Brian Alexander Peshek, M.D.
• Peter Foster-Fishman, Psy.D.
• Peter H. Lauber, PH.D.,P.C.
• Michael K Peters, DDS MS
• Van-Anh Tran Peters, DDS

• Psychologist in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Psychologist in Michigan

• 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.

Verify at the official NPI Registry.