Individual provider Active NPI

Debra K Carter, PHD

  • Forensic Psychologist
  • Bradenton, FL
National Provider Identifier
1073672333
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic PsychologistTaxonomy code 103TF0200X
License
PY3897 Issued in FL
Practice address
4835 27TH St West
Suite 125
Bradenton, FL 34207
Phone
(941) 253-0064
Fax
(941) 753-2977
NPI assigned
Dec 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY3897 FL
Family Psychologist 103TF0000X PY3897 FL
Health Service Psychologist 103TH0100X PY3897 FL
Forensic Psychologist 103TF0200X PY3897 FL Primary

Addresses

Primary practice location

4835 27TH St West
Suite 125
Bradenton, FL 34207

Mailing address

4835 27TH St West
Suite 125
Bradenton, FL 34207
Phone (941) 253-0064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20101115001173 FL Practitioner - Clinical Psychologist 0446224273 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY3897FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Debra K Carter PH D & Associates PA Clinical CurrentSince Jul 29, 1999 Accepting new patients

Locations

4835 27th St W
Ste 125
Bradenton, FL 34207
Phone (941) 753-0064

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: debrakcarterphd&associatespa.debracarter@135184.advancedmd-direct.com

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1073672333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4835 27TH ST WEST",
            "address_2": "SUITE 125",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34207",
            "telephone_number": "941-253-0064",
            "fax_number": "941-753-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4835 27TH ST WEST",
            "address_2": "SUITE 125",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34207",
            "telephone_number": "941-253-0064",
            "fax_number": "941-753-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "DEBRA",
        "middle_name": "K",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY3897",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "FL",
            "license": "PY3897",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "FL",
            "license": "PY3897",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "FL",
            "license": "PY3897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.