Active NPI
Perry J Bean, PSYD
- Psychologist
- Atlanta, GA
National Provider Identifier
1033286158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 000771
- Practice address
- 990 Hammond Dr NE
Ste 575
Atlanta, GA 30328-5529 - Phone
- (404) 843-1612
- Fax
- (404) 843-0948
- NPI assigned
- Nov 30, 2006
- Last updated
- Jan 14, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 000771 | GA | Primary |
Addresses
Primary practice location
990 Hammond Dr NE
Ste 575
Atlanta, GA 30328-5529
Mailing address
990 Hammond Dr NE
Ste 575
Atlanta, GA 30328-5529
Phone (404) 843-1612
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2014 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000771 | GA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200268800000",
"number": "1033286158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "990 HAMMOND DR NE",
"address_2": "STE 575",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303285529",
"telephone_number": "404-843-1612",
"fax_number": "404-843-0948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "990 HAMMOND DR NE",
"address_2": "STE 575",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303285529",
"telephone_number": "404-843-1612",
"fax_number": "404-843-0948"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAN",
"first_name": "PERRY",
"middle_name": "J",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-30",
"last_updated": "2008-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "GA",
"license": "000771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.