Individual provider Active NPI

Matthew Yoder, PHD

  • Clinical Psychologist
  • Charlottesville, VA
National Provider Identifier
1639339476
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810004800 Issued in VA
Practice address
1007 E High St
Charlottesville, VA 22902-4841
Phone
(843) 324-4925
NPI assigned
Jun 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1153 SC
Clinical Psychologist 103TC0700X 0810004800 VA Primary

Addresses

Primary practice location

1007 E High St
Charlottesville, VA 22902-4841

Mailing address

1007 E High St
Charlottesville, VA 22902-4841
Phone (843) 324-4925

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0810004800VAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1639339476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 E HIGH ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229024841",
            "telephone_number": "843-324-4925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 E HIGH ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229024841",
            "telephone_number": "843-324-4925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YODER",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "1153",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; 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.