Active NPI
Kathryn F Fair, PHD
- Psychologist
- Decatur, IL
National Provider Identifier
1679675490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 071006363
- Practice address
- 3035 E Mound Rd
Decatur, IL 62526-9650 - Phone
- (217) 554-3000
- NPI assigned
- Sep 2, 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 071006363 | IL | Primary |
Addresses
Primary practice location
3035 E Mound Rd
Decatur, IL 62526-9650
Mailing address
3035 E Mound Rd
Decatur, IL 62526-9650
Phone (217) 554-3000
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
| License | State | Type | Specialty |
|---|---|---|---|
| 071006363 | IL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364947200000",
"number": "1679675490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3035 E MOUND RD",
"city": "DECATUR",
"state": "IL",
"postal_code": "625269650",
"telephone_number": "217-554-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3035 E MOUND RD",
"city": "DECATUR",
"state": "IL",
"postal_code": "625269650",
"telephone_number": "217-554-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIR",
"first_name": "KATHRYN",
"middle_name": "F",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-02",
"last_updated": "2013-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IL",
"license": "071006363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.