Individual provider Active NPI

Rebecca Tubbs, PSY.D

  • Clinical Neuropsychologist
  • Concord, MA
National Provider Identifier
1912217324
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
9257 Issued in MA
Practice address
336 Baker Ave Unit 1-14
Concord, MA 01742-2100
Phone
(978) 307-8354
Fax
(978) 636-6773
NPI assigned
Oct 19, 2010
Last updated
Jul 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 9257 MA Primary

Addresses

Primary practice location

336 Baker Ave Unit 1-14
Concord, MA 01742-2100

Mailing address

PO Box 1083
Concord, MA 01742-1083
Phone (978) 307-8354

Other practice location 1

9 Pond Ln Ste 3C
Concord, MA 01742-2863
Phone (978) 307-8354

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9257MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rebecca Tubbs PSYD PLLC Clinical Neuropsychologist CurrentSince Nov 8, 2020 Accepting new patients

Locations

336 Baker Ave
Unit 114
Concord, MA 01742
Phone (978) 307-8354

9 Pond Ln
Ste 3C
Concord, MA 01742
Phone (978) 307-8354

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": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1912217324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1083",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017421083",
            "telephone_number": "978-307-8354",
            "fax_number": "978-636-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 BAKER AVE UNIT 1-14",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422100",
            "telephone_number": "978-307-8354",
            "fax_number": "978-636-6773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9 Pond Ln Ste 3C",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "MA",
            "postal_code": "017422863",
            "country_code": "US",
            "telephone_number": "978-307-8354",
            "fax_number": "978-636-6773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUBBS",
        "first_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "9257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; 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.