Individual provider Active NPI

Charles T Rubio, PH.D.

  • Clinical Psychologist
  • Opelika, AL
National Provider Identifier
1902994270
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
220 Issued in AL
Practice address
2114 Executive Park Dr
Opelika, AL 36801-6042
Phone
(334) 749-5055
Fax
(334) 460-8900
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 220 AL Primary

Addresses

Primary practice location

2114 Executive Park Dr
Opelika, AL 36801-6042

Mailing address

2114 Executive Park Drive
Opelika, AL 36801-6042
Phone (334) 749-5055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20131029000228 AL Practitioner - Clinical Psychologist 3577798545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2101 Executive Park Dr
Opelika, AL 36801-6041
Phone (334) 749-5055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Charles T. Rubio PHD PC CurrentSince Oct 10, 2013 Accepting new patients

Locations

2101 Executive Park Dr
Opelika, AL 36801
Phone (334) 275-9579

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1902994270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 EXECUTIVE PARK DRIVE",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368016042",
            "telephone_number": "334-749-5055",
            "fax_number": "334-460-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 EXECUTIVE PARK DR",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368016042",
            "telephone_number": "334-749-5055",
            "fax_number": "334-460-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIO",
        "first_name": "CHARLES",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Opelika, AL

Sources for this page

Verify at the official NPI Registry.