Philip Barry, PHD
Individual provider Active NPI Clinical Neuropsychologist · Tempe, AZ
NPI 1851348833 · NPPES record last updated Jan 19, 2012
Key facts
- NPI
- 1851348833
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Neuropsychologist 103G00000X
- License
- 1534 (AZ)
- Practice address
- 2600 E Southern Ave Ste C3
Tempe, AZ 85282-7609 - Phone
- (480) 839-6264
- Fax
- (480) 839-2115
- NPI assigned
- May 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2018 through Jan 1, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1534 | AZ | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 1534 | AZ | Yes |
| Clinical Psychologist | 103TC0700X | 1534 | AZ |
Addresses
Primary practice location
2600 E Southern Ave Ste C3
Tempe, AZ 85282-7609
Mailing address
2600 E Southern Ave Ste C3
Tempe, AZ 85282-7609
Phone (480) 839-6264
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 078601 | Medicaid | AZ |
Other providers in Tempe, AZ
- William R Barnes Jr.
- Desiree Barnett
- Eden Elizabeth Barnett
- Carrie Barrett
- Erika Barrios
- Casey Bartel
- Thad Edward Bartell
- Debra Lynn Bartine
- Olivia Lynn Bartola
- Benjamin M Barton
All providers in Tempe, AZ · Clinical Neuropsychologist in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.