Individual provider Active NPI

Jeremy Daniel English, PSY.D.

  • Clinical Psychologist
  • Evansville, IN
National Provider Identifier
1679060248
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20042682A Issued in IN
Practice address
3400 Lincoln Ave
Evansville, IN 47714-0146
Phone
(812) 469-6800
NPI assigned
Apr 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 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 20042682A IN Primary

Addresses

Primary practice location

3400 Lincoln Ave
Evansville, IN 47714-0146

Mailing address

3400 Lincoln Ave
Evansville, IN 47714-0146
Phone (812) 469-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20180806001715 IN Practitioner - Clinical Psychologist 2668720715 Reassigns benefits to 1 organization

National Provider Directory

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

Organizations & group practices 1

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": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1679060248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 LINCOLN AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140146",
            "telephone_number": "812-469-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 LINCOLN AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140146",
            "telephone_number": "812-469-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGLISH",
        "first_name": "JEREMY",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-18",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042682A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.