Active NPI
Arthur Kupersmith, PHD., HSPP
- Clinical Psychologist
- Marion, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LIC20090165A
- Practice address
- 101 S Washington St
Marion, IN 46952-3867 - Phone
- (765) 662-9971
- Fax
- (765) 651-6556
- NPI assigned
- Aug 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Psychologist | 103TH0100X | |||
| Psychologist | 103T00000X | |||
| Clinical Psychologist | 103TC0700X | LIC20090165A | IN | Primary |
| Counseling Psychologist | 103TC1900X | LIC20090165A | IN |
Addresses
Primary practice location
101 S Washington St
Marion, IN 46952-3867
Mailing address
101 S Washington St
Marion, IN 46952-3867
Phone (765) 662-9971
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100123560A | Medicaid | IN | |
| 000000317611 | Other | IN | ANTHEM |
| 4027 | Other | IN | MPLAN |
| 776095000 | Other | IN | MAGELLAN |
| 350868083 | Other | IN | TRICARE |
| 88367428 | Other | IN | CIGNA |
| 177120A | Other | IN | MEDICARE |
| 66108 | Other | IN | VALUE OPTIONS |
| LIC34001263A | Other | IN | VALUE OPTIONS - GM CLIENTS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1974
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
101 S Washington St
Marion, IN 46952-3867
Phone (765) 622-9971
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LIC20090165A | IN | MD | Counseling Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grant-Blackford Mental Health, Inc. | Current | Accepting new patients | |
| Grant-Blackford Mental Health, Inc. | Current | Accepting new patients |
Locations
410 Pilgrim Blvd
Ste 100
Hartford City, IN 47348
Phone (765) 348-1303
3010 S Adams St
Marion, IN 46953
Phone (765) 662-3971
505 N Wabash Ave
Marion, IN 46952
Phone (765) 662-3971
101 S Washington St
Marion, IN 46952
Phone (765) 662-9971
101 S Washington St
Ste 200
Marion, IN 46952
Phone (765) 662-9971
116 E 32nd St
Marion, IN 46953
Phone (765) 662-2039
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Marion, IN
- NPI 1407848500
-
- Community/Behavioral Health Agency
- Marion, IN
- NPI 1437983103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453939200000",
"number": "1861505059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 S WASHINGTON ST",
"city": "MARION",
"state": "IN",
"postal_code": "469523867",
"telephone_number": "765-662-9971",
"fax_number": "765-651-6556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 S WASHINGTON ST",
"city": "MARION",
"state": "IN",
"postal_code": "469523867",
"telephone_number": "765-662-9971",
"fax_number": "765-651-6556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUPERSMITH",
"first_name": "ARTHUR",
"name_prefix": "Dr.",
"credential": "PHD., HSPP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-15",
"last_updated": "2016-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "LIC20090165A",
"primary": true
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "IN",
"license": "LIC20090165A",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100123560A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000317611",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MPLAN",
"identifier": "4027",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "776095000",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "350868083",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "88367428",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "177120A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "66108",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS - GM CLIENTS",
"identifier": "LIC34001263A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Marion, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; 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.