Active NPI
John Wade Lobb, PHD
- Psychologist
- Du Bois, PA
National Provider Identifier
1528002573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS-005831-L
- Practice address
- 635 Maple Ave
Du Bois, PA 15801-2376 - Phone
- (814) 375-6379
- Fax
- (814) 375-9320
- NPI assigned
- Jun 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS-005831-L | PA | Primary |
Addresses
Primary practice location
635 Maple Ave
Du Bois, PA 15801-2376
Mailing address
100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-6379
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001655569 | Other | PA | HIGHMARK BC/BS |
| 0019472430004 | Medicaid | PA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS-005831-L | PA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351641600000",
"number": "1528002573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HOSPITAL AVE",
"city": "DU BOIS",
"state": "PA",
"postal_code": "158011440",
"telephone_number": "814-375-6379",
"fax_number": "814-375-9320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "635 MAPLE AVE",
"city": "DU BOIS",
"state": "PA",
"postal_code": "158012376",
"telephone_number": "814-375-6379",
"fax_number": "814-375-9320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOBB",
"first_name": "JOHN",
"middle_name": "WADE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-16",
"last_updated": "2012-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS-005831-L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BC/BS",
"identifier": "001655569",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0019472430004",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Du Bois, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.