KIMBERLY E DIONYSUS (NPI# 1164709747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164709747 |
| Entity Type | Individual |
| Full Name | KIMBERLY E DIONYSUS |
| Other Name | KIMBERLY E. DIOUNYSUS |
| Credential | PSYD |
| Practice Address |
2030 S National Ave Ste 105 Springfield MO 65804-2238 |
| Practice Telephone | 4178209590 |
| Mailing Telephone | 4178209590 |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2020-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | 071009108 | IL | Behavioral Health & Social Service Providers |
| Y | 103G00000X | Clinical Neuropsychologist | 2011037843 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MP | 1164709747 | 05 | |
| OK | 200437390A | 05 | |
| KS | 200750120A | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2115 S Fremont Ave Ste 3000, Springfield, MO 658042215 | 4178207708 | |
| 1025 Maine St, Quincy, IL 623014038 | 2172226550 |
| Street Address |
2030 S NATIONAL AVE STE 105 |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-2238 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578533758 | Amy Elizabeth Kessinger | Psychologist | 2030 S National Ave Ste 105, Springfield, MO 65804-2238 | 2006-01-23 |
| 1992981195 | Erin Golden | Psychologist | 2030 S National Ave Ste 105, Springfield, MO 65804-2238 | 2008-01-17 |
| 1801934765 | Pamela Forsyth | Psychologist | 2030 S National Ave Ste 105, Springfield, MO 65804-2222 | 2007-02-02 |
| 1053459834 | John Robert Essman | Clinical Neuropsychologist | 2030 S National Ave Ste 105, Springfield, MO 65804-2222 | 2007-02-02 |
| 1831237619 | Joseph Allen Pulleyking | Psychologist | 2030 S National Ave Ste 105, Springfield, MO 65804-2222 | 2007-02-02 |
| 1508904459 | Nancy L Breuer | Psychologist | 2030 S National Ave Ste 105, Springfield, MO 65804-2222 | 2007-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| 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 |
|---|---|---|---|---|
| 1194850859 | Murrell Counseling Service, LLC | Clinical Neuropsychologist | 2200 E Sunshine St Ste 312, Springfield, MO 65804-1883 | 2007-02-22 |
| 1356424972 | Frederick A Ulam IIi | Clinical Neuropsychologist | 516 E Catalpa St, Springfield, MO 65807-1614 | 2006-10-24 |
| 1205864998 | Deborah A. Fein | Clinical Neuropsychologist | 155 Maple St, Suite 407, Springfield, MA 01105-1828 | 2006-06-29 |
| 1346294493 | Michelle Papka Puri | Clinical Neuropsychologist | 195 Mountain Ave, Springfield, NJ 07081-1755 | 2006-05-22 |
| 1306843735 | Michael Whetstone | Clinical Neuropsychologist | 2115 S Fremont Ave Ste 3000, Springfield, MO 65804-2215 | 2005-06-30 |
| 1437773454 | Alphonso Smith | Clinical Neuropsychologist | 319 E Madison St Fl 3, Springfield, IL 62701-1035 | 2020-06-05 |
| 1093349888 | Lindsay Nguyen Vo | Clinical Neuropsychologist | 1300 E Bradford Pkwy, Springfield, MO 65804-4264 | 2020-03-02 |
| 1992289425 | Jacob Levi Priluck | Clinical Neuropsychologist | 6120 Brandon Ave, Springfield, VA 22150-2522 | 2018-09-20 |
| 1295230431 | Jessica Di Marco | Clinical Neuropsychologist | 29 Ridgewood Rd, Springfield, VT 05156-3060 | 2018-03-29 |
| 1205355542 | Jessica Degaetano | Clinical Neuropsychologist | 195 Mountain Ave, Springfield, NJ 07081-1755 | 2017-09-19 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
Please comment or provide details below to improve the information on KIMBERLY E DIONYSUS.
| 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.