Individual provider Active NPI

Beth A. Trammell, PH.D., HSPP

  • Clinical Psychologist
  • Muncie, IN
National Provider Identifier
1699893883
Registry record updated May 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20042638A Issued in IN
Practice address
1904 W Royale Dr
Muncie, IN 47304-2264
Phone
(765) 284-0443
Fax
(765) 284-4112
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20042638A IN Primary
School Psychologist 103TS0200X 20042638A IN
Psychologist 103T00000X 20042638A IN

Addresses

Primary practice location

1904 W Royale Dr
Muncie, IN 47304-2264

Mailing address

1904 W Royale Dr
Muncie, IN 47304-2264
Phone (765) 284-0043

Other identifiers 2

IdentifierTypeStateIssuer
100270530AMedicaidIN
201089430MedicaidIN

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

LicenseStateTypeSpecialty
20042638AINMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398902400000",
    "number": "1699893883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 W ROYALE DR",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473042264",
            "telephone_number": "765-284-0043",
            "fax_number": "765-284-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 W ROYALE DR",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473042264",
            "telephone_number": "765-284-0443",
            "fax_number": "765-284-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAMMELL",
        "first_name": "BETH",
        "middle_name": "A.",
        "credential": "PH.D., HSPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2014-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042638A",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "IN",
            "license": "20042638A",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20042638A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100270530A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201089430",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2014; 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.