Individual provider Active NPI

Brett Dowdy, PSYD

  • Clinical Psychologist
  • Mason, OH
National Provider Identifier
1003854712
Registry record updated Sep 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5809 Issued in OH
Practice address
4075 Old Western Row Rd
Mason, OH 45040-3104
Phone
(513) 536-0615
Fax
(513) 536-0619
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1243 KY
Clinical Psychologist 103TC0700X 5809 OH Primary

Addresses

Primary practice location

4075 Old Western Row Rd
Mason, OH 45040-3104

Mailing address

4075 Old Western Row Rd
Mason, OH 45040-3104
Phone (513) 536-0615

Other identifiers 1

IdentifierTypeStateIssuer
184607OtherKYMEDICARE GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20031209000002 OH Practitioner - Clinical Psychologist 4385540756 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lindner Center of Hope Professional AssociatesGroup PAC ID 7012236409, 72 clinicians

Practice addresses (Care Compare)

9435 Waterstone Blvd
Suite 120
Cincinnati, OH 45249-8227
Phone (513) 536-0639

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1243KYMDPsychologist
5809OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lindner Center of Hope Professional Associates Psychologist CurrentSince Mar 28, 2015 Accepting new patients
The Craig and Frances Lindner Center of Hope CurrentSince Aug 18, 2008 Accepting new patients
Northern Kentucky Mental Health Mental Retardation Regional Board Past Accepting new patients

Locations

9435 Waterstone Blvd
Ste 120
Cincinnati, OH 45249
Phone (513) 536-0639

4075 Old Western Row Rd
Mason, OH 45040
Phone (513) 536-0232

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221177600000",
    "number": "1003854712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4075 OLD WESTERN ROW RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450403104",
            "telephone_number": "513-536-0615",
            "fax_number": "513-536-0619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4075 OLD WESTERN ROW RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450403104",
            "telephone_number": "513-536-0615",
            "fax_number": "513-536-0619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOWDY",
        "first_name": "BRETT",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2008-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "1243",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "5809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "184607",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.