Charles Glenn Doyle, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2004033755 Issued in MO

Practice address

1230 N Duquesne Rd
Joplin, MO 64801-1509

Phone

(417) 782-1443

Fax

(417) 782-3240

NPI assigned

Dec 12, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Clinical Psychologist

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

College Skyline Center LLCGroup PAC ID 0749383842, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• College Skyline Center LLC

  • Clinic/Center
  • Joplin, MO
  • NPI 1598764110
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1134345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1821073909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 N DUQUESNE RD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648011509",
            "telephone_number": "417-782-1443",
            "fax_number": "417-782-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 N DUQUESNE RD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648011509",
            "telephone_number": "417-782-1443",
            "fax_number": "417-782-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "CHARLES",
        "middle_name": "GLENN",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-12",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2004033755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495853517",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Frances Douglas
• Shelby L Douglas
• Donovan Kayne Dowell, PHARMD
• Shelby Dowell
• Christian E Dowling
• Kristin M Doyle
• Riley Paige Dozal, PLPC
• Dr. Michael Patterson, DDS, PC
• Dr. Michael S. Londe, PH.D., LLC
• Dr. Susan M. Haas, PC

• Clinical Psychologist in Joplin, MO
• Providers in Joplin, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.