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JACK ENNIS PSYD, HSPP
NPI 1194773028
Psychologist - Clinical in Indianapolis, IN

Active since May 04, 2006PECOS Enrolled
2160 N ILLINOIS ST, INDIANAPOLIS, IN 46202(317) 937-3700(317) 937-3710 Get Directions Write a Review

NPPES record last updated: March 15, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jack Ennis Psyd, Hspp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK ENNIS PSYD, HSPP (NPI 1194773028) is an individual clinical provider in Indianapolis, Indiana, licensed in Indiana (20040742) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194773028
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameJACK ENNISCredential: PSYD, HSPP
Location Address2160 N ILLINOIS STIndianapolis, IN 46202-1334
Mailing AddressPo Box 4323Terre Haute, IN 47804-0323 · (812) 231-8323 · Fax (812) 231-8400
Phone(317) 937-3700
Fax(317) 937-3710
Sole ProprietorNo
Enumeration DateMay 4, 2006
Last NPPES UpdateMarch 15, 2011
✔ NPI 1194773028 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in IN · 20040742
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
2160 N ILLINOIS ST, Indianapolis, IN 46202
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Other Identifiers 2

Medicaid200254160IN
Medicare ID-Type Unspecified608960CCIN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack Ennis Psyd, Hspp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46202 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$161.76 typical visit price
range $53.07 – $161.76
Typical copayment $40.44 (range $13.26 – $40.44)
Most-billed visit code 99205
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY WALING
Social Worker (Clinical)
2160 N ILLINOIS ST
INDIANAPOLIS, IN 46202
Marion County (317) 937-3700
GWYNE BAHLER LSW
Social Worker
2160 N ILLINOIS ST
INDIANAPOLIS, IN 46202
Marion County (317) 438-3242
ELAINE SULLIVAN
Counselor (Mental Health)
2160 N ILLINOIS ST
INDIANAPOLIS, IN 46202
Marion County (317) 937-3700
SARA BOYER PHD, HSPP
Psychologist
2160 N ILLINOIS ST
INDIANAPOLIS, IN 46202
Marion County (317) 937-3700
KATHERINE NEWTON LMHC
Counselor (Mental Health)
2160 N ILLINOIS ST
INDIANAPOLIS, IN 46202
Marion County (317) 937-3700
BRITTANY GIPSON LCSW
Social Worker (Clinical)
2160 N ILLINOIS ST
INDIANAPOLIS, IN 46202
Marion County (317) 837-9726
MASOOMA A SHEIKH MD
Psychiatry & Neurology (Psychiatry)
2160 N ILLINOIS ST
INDIANAPOLIS, IN 46202
Marion County (317) 272-3330
SUSAN GRANT
Social Worker (Clinical)
2160 N ILLINOIS ST
INDIANAPOLIS, IN 46202
Marion County (317) 937-3700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Ennis's NPI number?

The NPI number for Jack Ennis is 1194773028. It was assigned to this individual provider in the NPPES registry on May 4, 2006.

Where is Jack Ennis located?

Jack Ennis practices at 2160 N Illinois St, Indianapolis, IN 46202. The listed phone number is (317) 937-3700.

What is Jack Ennis's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jack Ennis enrolled in Medicare?

Yes. Jack Ennis is registered in the Medicare PECOS enrollment system.

What insurance does Jack Ennis accept?

Health plans from CareSource list Jack Ennis as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jack Ennis was last updated on March 15, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.