Active NPI
Beth A. Trammell, PH.D., HSPP
- Clinical Psychologist
- Muncie, IN
National Provider Identifier
1699893883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 20042638A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100270530A | Medicaid | IN | |
| 201089430 | Medicaid | IN |
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 |
|---|---|---|---|
| 20042638A | IN | MD | Clinical 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.