Robert Beedle, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20053875B Issued in IN

Practice address

3903 Indianapolis Blvd
East Chicago, IN 46312-2555

Phone

(219) 769-4005

Fax

(219) 937-5808

NPI assigned

Aug 2, 2023

Last updated

Nov 4, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southlake Community Mental Health Center IncGroup PAC ID 5991600355, 37 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southlake Community Mental Health Center Inc.

  dba Regional Mental Health Center

  • Clinic/Center
  • Merrillville, IN
  • NPI 1821081290
  Medicare reassignment Care Compare group NPD
• Southlake Community Mental Health Center, Inc.

  dba Regional Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Merrillville, IN
  • NPI 1477007292
  NPD (past)

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

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1982386751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 INDIANAPOLIS BLVD",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463122555",
            "telephone_number": "219-769-4005",
            "fax_number": "219-937-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 INDIANAPOLIS BLVD",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463122555",
            "telephone_number": "219-769-4005",
            "fax_number": "219-937-5808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEEDLE",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-02",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20043875A",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20053875B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neha Suhas Bapat, MD
• Todor Teddy Baric, PHARMD
• Raquel B Barreto Castro, R.N.
• Hunter Bates
• Latoyia Beal
• Hanna-Elyzabeth Faith Bejar
• Cynthia R Bejster, LCSW
• Alicia Berman, OTR/L
• Ladonna Berryhill, BA
• James Archie Blackwood, LSW

• Clinical Psychologist in East Chicago, IN
• Providers in East Chicago, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.