NPIMap

Organization Active NPI

Michael L Rupley PHD PC

Doing business as Michiana Psychological Associates

  • Psychologist
  • Mishawaka, IN
National Provider Identifier
1679741235
Registry record updated May 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20010350 Issued in IN
Legal business name
MICHAEL L RUPLEY PHD PC
Doing business as
Michiana Psychological Associates
Practice address
323 West 4TH Street
Mishawaka, IN 46544-1913
Phone
(574) 256-2258
Fax
(574) 256-2266
NPI assigned
Feb 18, 2008
Last updated
May 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2011

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

Authorized official

Name
Dr. Michael L Rupley, PHD HSPP PC
Title
Clinical Psychologist
Phone
(574) 256-2258

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 20010350 IN Primary

Addresses

Primary practice location

323 West 4TH Street
Mishawaka, IN 46544-1913

Mailing address

323 West 4TH Street
Mishawaka, IN 46544-1913
Phone (574) 256-2258

Other identifiers 3

IdentifierTypeStateIssuer
100089740MedicaidIN
000000214616OtherINANTHEM BLUE CROSS
100089740AMedicaidIN

Other names 1

  • MICHIANA PSYCHOLOGICAL ASSOCIATES Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304640000000",
    "number": "1679741235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 WEST 4TH STREET",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465441913",
            "telephone_number": "574-256-2258",
            "fax_number": "574-256-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 WEST 4TH STREET",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465441913",
            "telephone_number": "574-256-2258",
            "fax_number": "574-256-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL L RUPLEY PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-18",
        "last_updated": "2011-05-06",
        "status": "A",
        "authorized_official_last_name": "RUPLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "574-256-2258",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD HSPP PC"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20010350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100089740",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000214616",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100089740A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MICHIANA PSYCHOLOGICAL ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mishawaka, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; 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.