Active NPI
Emily Kardis, PSYD, HSPP
- Clinical Psychologist
- Pendleton, IN
National Provider Identifier
1881152668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 20042935A
- Practice address
- 4490 Reformatory Rd
Pendleton, IN 46064-9001 - Phone
- (765) 778-2107
- NPI assigned
- Mar 11, 2019
- Last updated
- Mar 11, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071009344 | IL | |
| Clinical Psychologist | 103TC0700X | 20042935A | IN | Primary |
Addresses
Primary practice location
4490 Reformatory Rd
Pendleton, IN 46064-9001
Mailing address
19129 Pierson CT
Noblesville, IN 46060-7022
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071009344 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552262400000",
"number": "1881152668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19129 PIERSON CT",
"city": "NOBLESVILLE",
"state": "IN",
"postal_code": "460607022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4490 REFORMATORY RD",
"city": "PENDLETON",
"state": "IN",
"postal_code": "460649001",
"telephone_number": "765-778-2107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KARDIS",
"first_name": "EMILY",
"name_prefix": "Dr.",
"credential": "PSYD, HSPP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-11",
"last_updated": "2019-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071009344",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "20042935A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pendleton, IN
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- Sandy Mitchell Kimpel, LCSW
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- Frank J Lagoni Jr., D.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.