Robert Matthew Mindrup, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P2924 Issued in TN

Practice address

4330 Maynardville Hwy
Maynardville, TN 37807-3618

Phone

(865) 992-3849

Fax

(865) 992-5166

NPI assigned

Sep 9, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521763200000",
    "number": "1598098527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 SULPHUR SPRINGS RD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378135654",
            "telephone_number": "800-355-3565",
            "fax_number": "423-714-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 MAYNARDVILLE HWY",
            "city": "MAYNARDVILLE",
            "state": "TN",
            "postal_code": "378073618",
            "telephone_number": "865-992-3849",
            "fax_number": "865-992-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINDRUP",
        "first_name": "ROBERT",
        "middle_name": "MATTHEW",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-09",
        "last_updated": "2018-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P2924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurice A McCord, PNP-BC
• Ian Carter McCormick, PHARMD
• Paula Renee Miksa, PA-C
• Carly Miller
• Cynthia Donehew Milligan, RN
• Mission Hope Pediatric Therapy LLC
• Mohammad Bhidya MD PC
• Hal Martin Moncier, MD
• Felicia Savannah Cook Morris, LADAC II
• Lydia Rose Nerren, BSSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; 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.