Individual provider Active NPI

Richard Alan Gianfagna, PH.D.

  • Clinical Psychologist
  • Richmond, IN
National Provider Identifier
1508847260
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20010442A Issued in IN
Practice address
408 S 14TH St
Richmond, IN 47374-6403
Phone
(765) 935-5344
Fax
(765) 966-8338
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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 20010442A IN Primary

Addresses

Primary practice location

408 S 14TH St
Richmond, IN 47374-6403

Mailing address

408 S 14TH St
Richmond, IN 47374-6403
Phone (765) 935-5344

Other identifiers 1

IdentifierTypeStateIssuer
100256150AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20010442AINMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
McClain Chiropractic, LLC Past Accepting new patients
Richard a Gianfagna, PH,D., P.C. Clinical PastSince Dec 29, 2011 Accepting new patients

Organizations & group practices 2

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": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285804800000",
    "number": "1508847260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 S 14TH ST",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473746403",
            "telephone_number": "765-935-5344",
            "fax_number": "765-966-8338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 S 14TH ST",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473746403",
            "telephone_number": "765-935-5344",
            "fax_number": "765-966-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIANFAGNA",
        "first_name": "RICHARD",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2010-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20010442A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100256150A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; 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.