Individual provider Active NPI

Dana Beth Turnbull, PH.D.

  • Clinical Psychologist
  • Southlake, TX
National Provider Identifier
1558304691
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
31454 Issued in TX
Practice address
305 Miron Dr
Southlake, TX 76092-7831
Phone
(817) 571-2899
Fax
(817) 571-9879
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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 31454 TX Primary

Addresses

Primary practice location

305 Miron Dr
Southlake, TX 76092-7831

Mailing address

12701 Beech Tree LN
Euless, TX 76040-3427
Phone (817) 571-2899

Other identifiers 2

IdentifierTypeStateIssuer
00478YOtherTXMEDICARE PTAN
0417750-04MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20050322000307 TX Practitioner - Clinical Psychologist 3274588314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

305 Miron Dr
Southlake, TX 76092-7831
Phone (817) 571-2899

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31454TXMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
H. E. B. Behavioral Medicine, P. C. Clinical CurrentSince Dec 1, 2004 Accepting new patients

Locations

1912 Central Dr
Ste A
Bedford, TX 76021
Phone (817) 355-5200

305 Miron Dr
Southlake, TX 76092
Phone (682) 554-2946

Organizations & group practices 1

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1558304691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12701 BEECH TREE LN",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760403427",
            "telephone_number": "817-571-2899",
            "fax_number": "817-571-9879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MIRON DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760927831",
            "telephone_number": "817-571-2899",
            "fax_number": "817-571-9879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TURNBULL",
        "first_name": "DANA",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "31454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "00478Y",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0417750-04",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

Verify at the official NPI Registry.