Dwight David Tolliver

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6578 Issued in OH

Practice address

620 E Broad St Ste 301
Columbus, OH 43215-4037

Phone

(614) 914-6690

Fax

(614) 745-3344

NPI assigned

Mar 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Clinical Psychologist

Education

University of Tennessee, HSC, College of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dwight.tolliver.1@28621.direct.athenahealth.com

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.

• Real Psychological Services

  • Counseling Psychologist
  • Columbus, OH
  • NPI 1972314151
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1609909753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 E BROAD ST STE 301",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154037",
            "telephone_number": "614-914-6690",
            "fax_number": "147-453-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 E BROAD ST STE 301",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154037",
            "telephone_number": "614-914-6690",
            "fax_number": "614-745-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLIVER",
        "first_name": "DWIGHT",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "6578",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "OH",
            "license": "6578",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordyn Toller
• Jacarri Tollette
• Cosette E. Tolley, APRN-CNP
• Tollin Healthcare Services LLC
• Davonte Rashaun Tolliver
• Mahala Marie Jo Tolliver
• Roberta Jeanene Tolliver, HHA
• Shay Tolliver, QMHS
• Yolanda Delores Tolliver
• Ali Louise Tolloti, RD

• Psychologist in Columbus, OH
• Providers in Columbus, OH by specialty
• Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.