Active NPI
Greg Matthew Vanarsdall, PSY.D.
- Clinical Psychologist
- Dayton, OH
National Provider Identifier
1841358785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6221
- Practice address
- 5045 N Main St
Suite 223
Dayton, OH 45415-3698 - Phone
- (937) 276-3356
- NPI assigned
- Dec 4, 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6221 | OH | Primary |
Addresses
Primary practice location
5045 N Main St
Suite 223
Dayton, OH 45415-3698
Mailing address
4477 Sentry Hill CT
Kettering, OH 45440-4410
Phone (937) 580-6471
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 |
|---|---|---|---|
| 6221 | OH | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cordell Associates, LLC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Psychologist
- Dayton, OH
- NPI 1780735597
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305849600000",
"number": "1841358785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4477 SENTRY HILL CT",
"city": "KETTERING",
"state": "OH",
"postal_code": "454404410",
"telephone_number": "937-580-6471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5045 N MAIN ST",
"address_2": "SUITE 223",
"city": "DAYTON",
"state": "OH",
"postal_code": "454153698",
"telephone_number": "937-276-3356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANARSDALL",
"first_name": "GREG",
"middle_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2011-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "6221",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.