Active NPI
Amy Bax, PHD
- Clinical Psychologist
- Indianapolis, IN
National Provider Identifier
1629035134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 20041553
- Practice address
- 550 University Blvd
Uh 4100
Indianapolis, IN 46202-5149 - Phone
- (317) 274-3960
- NPI assigned
- Apr 27, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 20041553 | IN | Primary |
Addresses
Primary practice location
550 University Blvd
Uh 4100
Indianapolis, IN 46202-5149
Mailing address
550 N Meridian St
Ste 114
Indianapolis, IN 46204-1207
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20041553 | IN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194566400000",
"number": "1629035134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 N MERIDIAN ST",
"address_2": "STE 114",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462041207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 UNIVERSITY BLVD",
"address_2": "UH 4100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462025149",
"telephone_number": "317-274-3960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAX",
"first_name": "AMY",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-27",
"last_updated": "2007-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "20041553",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.