DR. JOHN MICHAEL SPORES (PH.D., J.D.) – Clinical Psychologist, NPI 1730176587
Clinical Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. JOHN MICHAEL SPORES (PH.D., J.D.)
Willowcreek Road, Willow Creek, Portage, Porter County, Indiana, 46368, United States
PORTAGE, IN 463685015
Phone: (219) 762-9556
Fax: (219) 762-7318
Type: Mailing
2110 SHERWOOD DR
VALPARAISO, IN 463852819
Phone: (219) 762-9556
Fax: (219) 762-7318
Type: Mailing
3349 WILLOWCREEK RD
VALPARAISO, IN 463685015
Phone: (219) 762-9556
Fax: (219) 762-7318
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2009-05-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090513000008 | I | Clinical Psychologist | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 46368)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | IN | |
| Mental Health Counselor | IN | |
| Clinical Psychologist | IL | |
| Mental Health Counselor | IL | |
| Nurse Practitioner | IN | |
| Mental Health Counselor | IN | |
| P S Y C H I A T R Y | MD | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| Clinical Social Worker | IN |
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