Nancy Kathryn Ravitch, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

22215 Issued in OR

Practice address

1193 Pearl St
Eugene, OR 97401-3521

Phone

(541) 321-6821

NPI assigned

Aug 15, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Eugene Pediatric Associates LLC

  • Pediatric Adolescent Medicine Physician
  • Eugene, OR
  • NPI 1659442960
  NPD (past)

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1063769586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 S GARDEN WAY STE 190",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018184",
            "telephone_number": "541-321-6821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1193 PEARL ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013521",
            "telephone_number": "541-321-6821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVITCH",
        "first_name": "NANCY",
        "middle_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-15",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "2630",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "OR",
            "license": "22215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Elizabeth Rasor
• Christine Lise Ratchinsky, PHYSICAL THERAPIST
• Tracy Jane Raulston, BCBA
• Quentin Rauschenbusch-Rowan
• Chad Ravert, LMT
• Melanie Rawlings, D.D.S.
• Sherrie A. Rawlins, M.D.
• Kelli Joel Ray
• Raymond Charles Ray, MD
• Rebecca Erin Ray

• Clinical Child & Adolescent Psychologist in Eugene, OR
• Providers in Eugene, OR by specialty
• Clinical Child & Adolescent Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; 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.