DR. CORBY ALAN BUBP (NPI# 1134136229) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134136229 |
| Entity Type | Individual |
| Full Name | DR. CORBY ALAN BUBP |
| Credential | PH.D. |
| Practice Address |
10293 N Meridian St Indianapolis IN 46290-1123 |
| Mailing Address |
10291 N Meridian St Ste 310 Indianapolis IN 46290-1083 |
| Practice Telephone | 3175812288 |
| Practice Fax Number | 3175812295 |
| Mailing Telephone | 3175812288 |
| Mailing Fax Number | 3175812295 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2019-12-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 20042024 | IN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200504340 | 05 |
| Street Address |
10293 N MERIDIAN ST |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46290-1123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548256795 | Kevin Patrick Dugan | Psychologist | 10293 N Meridian St, Suite 375, Indianapolis, IN 46290-1123 | 2005-09-23 |
| 1982247151 | Pia Shrontz | Counselor | 10293 N Meridian St, Indianapolis, IN 46290-1123 | 2019-10-21 |
| 1407397276 | Capturing Hope Counseling LLC | Community/Behavioral Health | 10293 N Meridian St, Suite 180, Indianapolis, IN 46290-1123 | 2017-03-13 |
| 1194183145 | Mary Katherine Degrella | Social Worker | 10293 N Meridian St, 310, Indianapolis, IN 46290-1123 | 2016-02-05 |
| 1306012729 | Wayne E. Hoye | Clinical Neuropsychologist | 10293 N Meridian St, Suite 375, Indianapolis, IN 46290-1123 | 2008-05-06 |
| 1689859803 | Bonnie Kay Pisano | Psychologist | 10293 N Meridian St, Suite 375, Indianapolis, IN 46290-1123 | 2008-01-07 |
| 1306057427 | Howard Brumbaugh Md PC | Ophthalmology | 10293 N Meridian St, Suite 325, Indianapolis, IN 46290-1123 | 2007-05-24 |
| 1083836449 | Joseph John Fata | Surgery | 10293 N Meridian St, Suite 200, Indianapolis, IN 46290-1123 | 2007-05-03 |
| 1750500740 | Judi Ann Green | Social Worker | 10293 N Meridian St, Indianapolis, IN 46290-1123 | 2007-04-25 |
| 1124176961 | Professional Psychological Services | Psychologist | 10293 N Meridian St, Suite 375, Indianapolis, IN 46290-1123 | 2007-01-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821548777 | American Behavioral Counseling | Social Worker | 10386 Spring Highland Dr, Indianapolis, IN 46290 | 2016-10-04 |
| 1518042431 | James Lamar Jones | Psychologist | 8555 Cedar Place, Suite 113a, Indianapolis, IN 46290 | 2006-10-26 |
| 1437245917 | Bradley Scott Gunter | Physical Therapy Assistant | 10601 N. Meridian St., Suite 110, Indianapolis, IN 46290 | 2006-10-04 |
| 1790261576 | Kristiana Michelle Sannella | Physician Assistant | 10590 N Meridian St # 105, Indianapolis, IN 46290 | 2018-07-16 |
| 1023534815 | Mitchell James Vansumeren | Psychologist | 10291 N Meridian St Ste 310, Indianapolis, IN 46290 | 2017-08-14 |
| 1801281670 | Elizabeth Tibbs | Physician Assistant | 10590 N Meridian St Ste 105, Indianapolis, IN 46290 | 2015-03-30 |
| 1447510722 | Bradley A Clark | Internal Medicine | 10590 N Meridian St, Indianapolis, IN 46290 | 2012-05-21 |
| 1528333861 | Edward Mark Shmukler | Internal Medicine | 10590 N Meridian St, Indianapolis, IN 46290 | 2012-03-20 |
| 1386938272 | Bryce S Lynn | Internal Medicine | 10590 N Meridian St, Indianapolis, IN 46290 | 2011-06-08 |
| 1063610301 | Babar Sultan | Otolaryngology | 170 W 106th St, Meridian Plastic Surgery, Indianapolis, IN 46290 | 2007-07-09 |
| Find all providers in zip 46290 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497273015 | Jana Beth Dykstra | Clinical Neuropsychologist | 355 W 16th Street Goodman Hall, Indianapolis, IN 46202 | 2017-09-04 |
| 1558779355 | Neurobehavioral Consultants, LLC | Clinical Neuropsychologist | 4356 N College Ave, Indianapolis, IN 46205-1932 | 2014-07-24 |
| 1306170626 | Elizabeth Begyn | Clinical Neuropsychologist | 541 Clinical Dr # Cl285, Indianapolis, IN 46202-5233 | 2009-09-21 |
| 1215101696 | Michelle Anne Keiski | Clinical Neuropsychologist | 355 W 16th St Ste 4700, Indianapolis, IN 46202-2285 | 2008-04-17 |
| 1447477088 | Robert Nolan Mckinney | Clinical Neuropsychologist | 2596 N Girls School Rd, Indianapolis, IN 46214-2105 | 2007-04-18 |
| 1003833096 | Raymond W Horn | Clinical Neuropsychologist | 10293 N Meridian St Ste 210, Indianapolis, IN 46290-1079 | 2006-07-16 |
| 1255327748 | Gwen C Sprehn | Clinical Neuropsychologist | Dept of Neurology Indiana University School of Med, 541 Clinical Drive (cl-299), Indianapolis, IN 46202 | 2005-09-21 |
| 1972595684 | Leslie Jay Suga | Clinical Neuropsychologist | 6515 E 82nd St, Suite 210, Indianapolis, IN 46250-1576 | 2005-08-18 |
| 1285639476 | Odie L Bracy IIi | Clinical Neuropsychologist | 6555 Carrollton Ave, Indianapolis, IN 46220-1664 | 2005-06-15 |
| 1811506769 | Midwest Supervision and Evaluation | Clinical Neuropsychologist | 450 E 96th St Ste 500, Indianapolis, IN 46240-3760 | 2020-07-27 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46290 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.