Individual provider Active NPI

Patricia Ruth Murray, EDD

  • Psychologist
  • Portage, MI
National Provider Identifier
1740371426
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301003305 Issued in MI
Practice address
8036 Moorsbridge Road
Suite #2
Portage, MI 49024-4417
Phone
(269) 327-1438
Fax
(269) 327-6454
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301003305 MI Primary

Addresses

Primary practice location

8036 Moorsbridge Road
Suite #2
Portage, MI 49024-4417

Mailing address

PO Box 2585
Portage, MI 49081-2585
Phone (269) 381-0150

Other identifiers 1

IdentifierTypeStateIssuer
135194OtherMIVALUE OPTIONS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20121115000329 MI Practitioner - Clinical Psychologist 6608027842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid America Psychological Services PCGroup PAC ID 1759374812, 6 clinicians

Practice addresses (Care Compare)

8036 Moorsbridge Rd
Suite 2
Portage, MI 49024-4417
Phone (269) 327-1438

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301003305MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-America Psychological Services, P. C. CurrentSince Aug 7, 2012 Accepting new patients
Eyeglass Acquisitions, Inc. Past Accepting new patients

Locations

3325 Greenleaf Blvd
Kalamazoo, MI 49008

8036 Moorsbridge Rd
Ste 2
Portage, MI 49024
Phone (269) 327-1438

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740371426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2585",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490812585",
            "telephone_number": "269-381-0150",
            "fax_number": "269-373-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8036 MOORSBRIDGE ROAD",
            "address_2": "SUITE #2",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244417",
            "telephone_number": "269-327-1438",
            "fax_number": "269-327-6454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "PATRICIA",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "EDD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301003305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "135194",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.