Individual provider Active NPI

Mona Lynne Tiernan, PSY.D.

  • Psychologist
  • Tampa, FL
National Provider Identifier
1912072398
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY9263 Issued in FL
Practice address
1 Tampa General Cir
Tampa, FL 33606-3571
Phone
(813) 844-8927
NPI assigned
Nov 21, 2006
Last updated
Jan 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 003009 CT
Psychologist 103T00000X 003009 CT
Psychologist 103T00000X PY9263 FL Primary

Addresses

Primary practice location

1 Tampa General Cir
Tampa, FL 33606-3571

Mailing address

PO Box 1289
Attn: Managed Care
Tampa, FL 33601-1289
Phone (813) 844-8927

Other identifiers 1

IdentifierTypeStateIssuer
008030090MedicaidCT

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

LicenseStateTypeSpecialty
003009CTMDPsychologist
003009NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Institute of Virginia Inc PastSince Aug 1, 2008 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1912072398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1289",
            "address_2": "ATTN: MANAGED CARE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336011289",
            "telephone_number": "813-844-8927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TAMPA GENERAL CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063571",
            "telephone_number": "813-844-8927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIERNAN",
        "first_name": "MONA",
        "middle_name": "LYNNE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CT",
            "license": "003009",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "003009",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY9263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008030090",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.