Robert M North Sr., ED.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P0000000878 Issued in TN

Practice address

118 Maupin Cir
Shelbyville, TN 37160-3781

Phone

(931) 680-7576

Fax

(931) 536-4346

NPI assigned

Jul 6, 2006

Last updated

Jul 25, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY, TN2 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

Specialty

Clinical Psychologist

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brownsville Medical Clinic, P.a.Group PAC ID 0547339772, 61 clinicians

BH Services Southeast 1 PCGroup PAC ID 7012457054, 96 clinicians

Ipc Pac Healthcare Services of Tennessee PCGroup PAC ID 0840587572, 74 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• BH Services Southeast 1 PC

  • Nurse Practitioner
  • Brownsville, TN
  • NPI 1164251526
  Medicare reassignment Care Compare group NPD
• Ipc Pac Healthcare Services of Tennessee PC

  • Internal Medicine Physician
  • Bristol, TN
  • NPI 1104277656
  Medicare reassignment Care Compare group NPD
• Geriatric Psychology Affiliates LLC

  • Clinical Psychologist
  • Shelbyville, TN
  • NPI 1417483421

  KY

  Medicare reassignment NPD
• CS Pacs 3 Southeast, LLC

  • Hospitalist Physician
  • Bluefield, WV
  • NPI 1154104958

  TN

  Medicare reassignment NPD
• NV Pacs 2 LLC

  • Hospitalist Physician
  • Las Vegas, NV
  • NPI 1427534809

  TN

  Medicare reassignment NPD
• Geriatric Psychology Affiliates LLC

  • Psychologist
  • Shelbyville, TN
  • NPI 1659847978
  Authorized official Same address or phone
• Psychopharmacology Associates, Inc.

  • Clinical Psychologist
  • Shelbyville, TN
  • NPI 1417988965
  NPD (past)
• Stellar Inc

  • Clinical Psychologist
  • Shelbyville, TN
  • NPI 1346278934
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1548291370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 MAUPIN CIR",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371603781",
            "telephone_number": "931-580-8936",
            "fax_number": "931-536-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 MAUPIN CIR",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371603781",
            "telephone_number": "931-680-7576",
            "fax_number": "931-536-4346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTH",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P0000000878",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "1300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3683721",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3683728",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Shelbyville, TN
• Providers in Shelbyville, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.