Individual provider Active NPI

Natalie Marie Scanlon, PHD

  • Psychologist
  • Round Rock, TX
National Provider Identifier
1922681311
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
38883 Issued in TX
Practice address
7700 Cat Hollow Dr Ste 206
Round Rock, TX 78681-5799
Phone
(845) 780-7512
Fax
(501) 225-9512
NPI assigned
May 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3701-57 WI
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 38883 TX Primary

Addresses

Primary practice location

7700 Cat Hollow Dr Ste 206
Round Rock, TX 78681-5799

Mailing address

11605 Sun Glide LN
Manor, TX 78653-3779
Phone (507) 421-2474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220425001588 TX Practitioner - Clinical Psychologist 6507253457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3601 4TH St
1A122
Lubbock, TX 79430-8103
Phone (806) 743-2800

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
87.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3701-57WIMDPsychologist
38883TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock Single Specialty CurrentSince May 1, 2022 Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince May 1, 2022 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Single Specialty Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock Single Specialty Current Accepting new patients

Locations

3601 4th St
#1A122
Lubbock, TX 79430
Phone (806) 743-2391

4000 24th St
#410
Lubbock, TX 79410
Phone (806) 743-7700

Organizations & group practices 4

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": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1922681311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11605 SUN GLIDE LN",
            "city": "MANOR",
            "state": "TX",
            "postal_code": "786533779",
            "telephone_number": "507-421-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 CAT HOLLOW DR STE 206",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786815799",
            "telephone_number": "845-780-7512",
            "fax_number": "501-225-9512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANLON",
        "first_name": "NATALIE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3701-57",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "38883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.