Active NPI
Michael John Yonkovig, PH.D.
- Psychologist
- Charlotte, NC
National Provider Identifier
1760568075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1463
- Practice address
- 1981 J N Pease PL
Suite 201
Charlotte, NC 28262-4526 - Phone
- (704) 366-3818
- Fax
- (704) 295-1991
- NPI assigned
- Oct 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1463 | NC | Primary |
Addresses
Primary practice location
1981 J N Pease PL
Suite 201
Charlotte, NC 28262-4526
Mailing address
1981 J N Pease PL
Suite 201
Charlotte, NC 28262-4545
Phone (704) 366-3818
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6000548 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective May 30, 2018 through May 30, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1463 | NC | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760568075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1981 J N PEASE PL",
"address_2": "SUITE 201",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282624545",
"telephone_number": "704-366-3818",
"fax_number": "704-295-1991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1981 J N PEASE PL",
"address_2": "SUITE 201",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282624526",
"telephone_number": "704-366-3818",
"fax_number": "704-295-1991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YONKOVIG",
"first_name": "MICHAEL",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "1463",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6000548",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.