Individual provider Active NPI

Aimee Noel Staley, PSYD

  • Clinical Neuropsychologist
  • Columbus, GA
National Provider Identifier
1063451847
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY003141 Issued in GA
Practice address
5652 Veterans Pkwy
Columbus, GA 31904-9002
Phone
(706) 507-5444
Fax
(706) 507-5484
NPI assigned
Jun 6, 2006
Last updated
Mar 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY003141 GA Primary

Addresses

Primary practice location

5652 Veterans Pkwy
Columbus, GA 31904-9002

Mailing address

5652 Veterans Pkwy
Columbus, GA 31904-9002
Phone (706) 507-5444

Other identifiers 1

IdentifierTypeStateIssuer
511I260052OtherGAMEDICARE GA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20110302000415 GA Practitioner - Clinical Psychologist 3173600608 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5652 Veterans Pkwy
Columbus, GA 31904-9002
Phone (706) 507-5444

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY003141GAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Psychology, P.C. Clinical Neuropsychologist CurrentSince Feb 10, 2015 Accepting new patients
Norman Flaten Todd & Hammond Neurologic Consultants PA Past Accepting new patients
Pain Center of Virginia, PLLC PastSince Sep 6, 2022 Accepting new patients
Columbus Psychological Assoc. Past Accepting new patients

Locations

4 Bradley Park Ct
Ste 1B
Columbus, GA 31904
Phone (706) 507-5444

5652 Veterans Pkwy
Columbus, GA 31904
Phone (706) 322-7351

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1063451847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5652 VETERANS PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319049002",
            "telephone_number": "706-507-5444",
            "fax_number": "706-507-5484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5652 VETERANS PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319049002",
            "telephone_number": "706-507-5444",
            "fax_number": "706-507-5484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALEY",
        "first_name": "AIMEE",
        "middle_name": "NOEL",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "GA",
            "license": "PSY003141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GA",
            "identifier": "511I260052",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.