Individual provider Active NPI

William Gibbs Elder Jr., PHD

  • Clinical Psychologist
  • Lexington, KY
National Provider Identifier
1033140306
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
38344 Issued in TX
Practice address
201 Price Rd Apt 106
Lexington, KY 40511-1980
Phone
(859) 227-4643
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 38344 TX Primary
Clinical Psychologist 103TC0700X 1108 KY

Addresses

Primary practice location

201 Price Rd Apt 106
Lexington, KY 40511-1980

Mailing address

1211 Caroline St Unit 1403
Houston, TX 77002-6937
Phone (859) 227-4643

Other identifiers 1

IdentifierTypeStateIssuer
89011084MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
38344TXMDDentist
1108KYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Uh Health Clinical CurrentSince Apr 20, 2022 Accepting new patients
Villagemd of Southeast Texas, PA PastSince Dec 14, 2025 Accepting new patients

Locations

4349 Martin Luther King Blvd
Ste 1001
Houston, TX 77204
Phone (713) 743-9682

4849 Calhoun Rd
Ste 1001A
Houston, TX 77204
Phone (346) 348-1201

4349 Martin Luther King Blvd
Ste 1001E
Houston, TX 77204
Phone (713) 743-9682

4349 Martin Luther King Blvd
#2
Houston, TX 77204
Phone (713) 743-9682

Interoperability endpoints

  • Direct secure messaging: william.elder.p1@direct.lscctx.nextgenshare.com
  • FHIR API: https://api.platform.athenahealth.com/26199/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1033140306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 CAROLINE ST UNIT 1403",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770026937",
            "telephone_number": "859-227-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PRICE RD APT 106",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111980",
            "telephone_number": "859-227-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDER",
        "first_name": "WILLIAM",
        "middle_name": "GIBBS",
        "name_suffix": "Jr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "38344",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "1108",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89011084",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.