Individual provider Active NPI

Howard Ryan Slutzky, PSYD

  • Psychologist
  • Cornelius, NC
National Provider Identifier
1063465078
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2431 Issued in NC
Practice address
18121 W Catawba Ave
Cornelius, NC 28031-5641
Phone
(704) 895-0085
Fax
(704) 895-2585
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2431 NC Primary

Addresses

Primary practice location

18121 W Catawba Ave
Cornelius, NC 28031-5641

Mailing address

12603 Windyedge Rd
Huntersville, NC 28078-2243
Phone (704) 895-0085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2431NCMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063465078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12603 WINDYEDGE RD",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280782243",
            "telephone_number": "704-895-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18121 W CATAWBA AVE",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280315641",
            "telephone_number": "704-895-0085",
            "fax_number": "704-895-2585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLUTZKY",
        "first_name": "HOWARD",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "2431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.