NPIMap

Organization Active NPI

Columbus Psychological Associates, LLP

  • Psychologist
  • Columbus, GA
National Provider Identifier
1073540589
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
COLUMBUS PSYCHOLOGICAL ASSOCIATES, LLP
Practice address
2325 Brookstone Centre Parkway
Columbus, GA 31904
Phone
(706) 653-6841
Fax
(706) 653-7843
NPI assigned
Jun 28, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jaimelyn Connell
Title
Office Manager
Phone
(706) 653-6841

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

2325 Brookstone Centre Parkway
Columbus, GA 31904

Mailing address

2325 Brookstone Centre Parkway
Columbus, GA 31904
Phone (706) 653-6841

Other identifiers 1

IdentifierTypeStateIssuer
055003759AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040421000466 GA Part B Supplier - Clinic/Group Practice 8527054162 Receives reassigned benefits from 14 practitioners
Practice locations: Columbus, GA

National Provider Directory

National Provider Directory
Tax ID family
Columbus Psychl Assoc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073540589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 BROOKSTONE CENTRE PARKWAY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31904",
            "telephone_number": "706-653-6841",
            "fax_number": "706-653-7843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 BROOKSTONE CENTRE PARKWAY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31904",
            "telephone_number": "706-653-6841",
            "fax_number": "706-653-7843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBUS PSYCHOLOGICAL ASSOCIATES, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CONNELL",
        "authorized_official_first_name": "JAIMELYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "706-653-6841"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055003759A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.