Rodney E Timbrook, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20041416A Issued in IN

Practice address

3421 E State Blvd
Fort Wayne, IN 46805-4830

Phone

(260) 482-8427

Fax

(260) 482-8429

NPI assigned

Jul 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Clinical Psychologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychological Service Associates, IncGroup PAC ID 3476528902, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Psychological Service Associates, Inc

  • Psychologist
  • Fort Wayne, IN
  • NPI 1558441063

  Clinical

  Medicare reassignment Care Compare group NPD
• Timbrook Psychological Services

  • Clinical Psychologist
  • Fort Wayne, IN
  • NPI 1730033101
  NPD Authorized official
• Herbert P. Trier, M.D.

  • Psychiatry Physician
  • Fort Wayne, IN
  • NPI 1477722197

  Clinical

  NPD (past)

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248048000000",
    "number": "1932108982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054830",
            "telephone_number": "260-482-8427",
            "fax_number": "260-482-8429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054830",
            "telephone_number": "260-482-8427",
            "fax_number": "260-482-8429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMBROOK",
        "first_name": "RODNEY",
        "middle_name": "E",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2009-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041416A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200368190",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew W Till
• Judy Ann Tillapaugh, RDN LD
• Jordan Michelle Tillman
• Timbrook Psychological Services
• Kelly Marie Timbrook, NP
• Jason Timmer, CPO
• Angie Timmons, COTA
• Timothy Jay Bussick DDS, Ms, Incorporated
• Timothy L. Johnson Academy
• Kayla Tin

• Clinical Psychologist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.