Individual provider Active NPI

Karin M Tonkin, PHD,HSPP

  • Clinical Psychologist
  • Indianapolis, IN
National Provider Identifier
1649396904
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20042162A Issued in IN
Practice address
6640 Intech Blvd
Suite 190
Indianapolis, IN 46278-2011
Phone
(317) 295-0608
Fax
(317) 295-0622
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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 20042162A IN Primary

Addresses

Primary practice location

6640 Intech Blvd
Suite 190
Indianapolis, IN 46278-2011

Mailing address

3937 Sunset Blvd Ste B
West Columbia, SC 29169-2423
Phone (803) 900-4890

Other identifiers 1

IdentifierTypeStateIssuer
200856830MedicaidIN

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

Practice roles

OrganizationSpecialtyStatusNew patients
LTC Therapy Solutions LLC CurrentSince Apr 10, 2018 Accepting new patients
Indiana University Health, Inc Clinical Past Accepting new patients

Locations

3681 Leaphart Rd
Ste A
West Columbia, SC 29169
Phone (803) 454-6090

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1649396904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3937 SUNSET BLVD STE B",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291692423",
            "telephone_number": "803-900-4890",
            "fax_number": "803-931-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6640 INTECH BLVD",
            "address_2": "SUITE 190",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462782011",
            "telephone_number": "317-295-0608",
            "fax_number": "317-295-0622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONKIN",
        "first_name": "KARIN",
        "middle_name": "M",
        "credential": "PHD,HSPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042162A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200856830",
            "state": "IN"
        }
    ],
    "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 Apr 11, 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.