Individual provider Active NPI

Nancy Vermont, PSYD

  • Clinical Psychologist
  • WHB, NY
National Provider Identifier
1083757363
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
10631 Issued in NY
Practice address
12 Oak St
WHB, NY 11978-0183
Phone
(631) 288-3558
Fax
(631) 288-9424
NPI assigned
Feb 15, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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
Clinical Psychologist 103TC0700X 10631 NY Primary

Addresses

Primary practice location

12 Oak St
WHB, NY 11978-0183

Mailing address

PO Box 183
Westhampton Beach, NY 11978-0183
Phone (631) 288-3558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20100621000773 NY Practitioner - Clinical Psychologist 1850422767 Practice locations: Riverhead, NY; Westhampton Beach, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12 Oak St
Westhampton Beach, NY 11978-2020
Phone (631) 288-3558

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10631NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083757363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 183",
            "city": "WESTHAMPTON BEACH",
            "state": "NY",
            "postal_code": "119780183",
            "telephone_number": "631-288-3558",
            "fax_number": "631-288-9424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 OAK ST",
            "city": "WHB",
            "state": "NY",
            "postal_code": "119780183",
            "telephone_number": "631-288-3558",
            "fax_number": "631-288-9424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERMONT",
        "first_name": "NANCY",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "10631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.