NPIMap

Individual provider Active NPI

Steven Roger Rumble, PH.D. HSPP

  • Psychologist
  • Indianapolis, IN
National Provider Identifier
1518091768
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20040148 Issued in IN
Practice address
650 E Southport Rd
Suite C
Indianapolis, IN 46227-8592
Phone
(317) 782-6015
Fax
(317) 782-6929
NPI assigned
Mar 16, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 20040148 IN Primary

Addresses

Primary practice location

650 E Southport Rd
Suite C
Indianapolis, IN 46227-8592

Mailing address

704 Covered Bridge Rd
Greenwood, IN 46142-1112
Phone (317) 887-6742

Other identifiers 2

IdentifierTypeStateIssuer
20040148OtherINHSPP (LICENTURE NO.)
100251760AMedicaidIN

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
20040148INMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Outpatient Behavioral Health, St Francis Hospital Center Past Accepting new patients
Major Hospital Past Accepting new patients
St. Francis Hospital and Health Centers Past Accepting new patients
St. Francis Hospital Past Accepting new patients

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518091768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 COVERED BRIDGE RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461421112",
            "telephone_number": "317-887-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 E SOUTHPORT RD",
            "address_2": "SUITE C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462278592",
            "telephone_number": "317-782-6015",
            "fax_number": "317-782-6929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUMBLE",
        "first_name": "STEVEN",
        "middle_name": "ROGER",
        "name_prefix": "Dr.",
        "credential": "PH.D. HSPP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20040148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HSPP (LICENTURE NO.)",
            "identifier": "20040148",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100251760A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.