Active NPI
Linda McIntire, HSPP
- Clinical Psychologist
- Shelbyville, IN
National Provider Identifier
1780656918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 20042156A
- Practice address
- 149 W Broadway St
Shelbyville, IN 46176-1201 - Phone
- (317) 298-7211
- Fax
- (317) 398-7210
- NPI assigned
- Feb 2, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 20042156A | IN | Primary |
Addresses
Primary practice location
149 W Broadway St
Shelbyville, IN 46176-1201
Mailing address
149 W Broadway St
Shelbyville, IN 46176-1201
Phone (317) 398-7211
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000321009 | Other | IN | ANTHEM PIN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20042156A | IN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239235200000",
"number": "1780656918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "149 W BROADWAY ST",
"city": "SHELBYVILLE",
"state": "IN",
"postal_code": "461761201",
"telephone_number": "317-398-7211",
"fax_number": "317-398-7210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "149 W BROADWAY ST",
"city": "SHELBYVILLE",
"state": "IN",
"postal_code": "461761201",
"telephone_number": "317-298-7211",
"fax_number": "317-398-7210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINTIRE",
"first_name": "LINDA",
"credential": "HSPP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-02",
"last_updated": "2009-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "20042156A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PIN",
"identifier": "000000321009",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shelbyville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.