Individual provider Active NPI

Andrew Arnold Sappington III, PSYCHOLOGIST

  • Psychologist
  • St Augustine, FL
National Provider Identifier
1063502383
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5706 Issued in FL
Practice address
1100 S Ponce de Leon Blvd Ste 1
Saint Augustine, FL 32084-6013
Phone
(904) 824-7733
Fax
(904) 829-9768
NPI assigned
Oct 15, 2006
Sex
Male
Sole proprietor
Yes

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 5706 FL Primary

Addresses

Primary practice location

1100 S Ponce de Leon Blvd Ste 1
Saint Augustine, FL 32084-6013

Mailing address

1100 S Ponce de Leon Blvd Ste 1
Saint Augustine, FL 32084-6013
Phone (904) 824-7733

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
5706FLMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Vericare of Florida, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1160870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063502383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S PONCE DE LEON BLVD STE 1",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320846013",
            "telephone_number": "904-824-7733",
            "fax_number": "904-829-9768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S PONCE DE LEON BLVD STE 1",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320846013",
            "telephone_number": "904-824-7733",
            "fax_number": "904-829-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAPPINGTON",
        "first_name": "ANDREW",
        "middle_name": "ARNOLD",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "5706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.