Individual provider Active NPI

Polly Jane Westcott, PSY.D.

  • Clinical Psychologist
  • Carmel, IN
National Provider Identifier
1649364985
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20042062A Issued in IN
Practice address
703 Pro-Med LN
Carmel, IN 46032-5317
Phone
(317) 843-9922
Fax
(317) 581-3918
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 20042062A IN Primary

Addresses

Primary practice location

703 Pro-Med LN
Carmel, IN 46032-5317

Mailing address

703 Pro-Med LN
Carmel, IN 46032-5317
Phone (317) 843-9922

Other names 1

  • Dr. Polly Hughes Shepard Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective May 8, 2017 through May 8, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20042062AINMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1649364985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 PRO-MED LN",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325317",
            "telephone_number": "317-843-9922",
            "fax_number": "317-581-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 PRO-MED LN",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325317",
            "telephone_number": "317-843-9922",
            "fax_number": "317-581-3918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTCOTT",
        "first_name": "POLLY",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042062A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "POLLY",
            "last_name": "SHEPARD",
            "middle_name": "HUGHES",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.