John Thomas Heroldt, ED.D., HSPP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20040372A Issued in IN

Practice address

717 Michigan Ave
La Porte, IN 46350-3371

Phone

(219) 874-2518

Fax

(219) 756-8945

NPI assigned

Jul 19, 2006

Last updated

Dec 14, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Associates in Clinical Practice

  • Clinical Psychologist
  • Merrillville, IN
  • NPI 1831250422
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197590400000",
    "number": "1699794644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1652 TIPPECANOE CT",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463856142",
            "telephone_number": "219-874-2518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 MICHIGAN AVE",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503371",
            "telephone_number": "219-874-2518",
            "fax_number": "219-756-8945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEROLDT",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "ED.D., HSPP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20040372A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Healthlinc, Inc
• Hendricks County Hospital (Brickyard Healthcare - LaPorte Care Center)
• Hendricks County Hospital (Brickyard Healthcare - Terrace Care Center)
• Beatrice M Hernandez, MD
• John Herod, RPH
• Pamela J Heyne-Thompson, O.D.
• Hickory Grove Behavioral Services, LLC (Hickory Grove Behavioral Services)
• Lawrence Allen Hicks, O.D.
• Hilbish Drug, Inc.
• Stephanie Hillyer, RD

• Clinical Psychologist in La Porte, IN
• Providers in La Porte, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.