Dodge Psychology Practice, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2002011102 Issued in MO

Legal business name

DODGE PSYCHOLOGY PRACTICE, LLC

Practice address

18975 W 115TH Ter
Olathe, KS 66061-6542

Phone

(913) 232-6861

NPI assigned

Mar 20, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Timothy D Dodge, PH.D.NPI 1598926362

Title

Owner

Phone

(913) 232-6861

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy Dean Dodge, PH.D.

  • Psychologist
  • Olathe, KS
  • NPI 1598926362
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1300579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346803200000",
    "number": "1962701755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18975 W 115TH TER",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660616542",
            "telephone_number": "913-232-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18975 W 115TH TER",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660616542",
            "telephone_number": "913-232-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DODGE PSYCHOLOGY PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-20",
        "last_updated": "2012-09-05",
        "status": "A",
        "authorized_official_last_name": "DODGE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-232-6861",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2002011102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Dinitto
• Alli Dippel
• Kimberly Dishman, WHNP
• Lisa L. Doane, M.D.
• Courtney Dodds
• Timothy Dean Dodge, PH.D.
• Theresa Doerfler, MA, LPC, NCC
• Kimberly Doerr, FNP-C
• Dennis Patrick Dolan, ATC
• Kristin Doll, AGNP-BC

• Clinical Psychologist in Olathe, KS
• Providers in Olathe, KS by specialty
• Clinical Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.