Bambi Lynn Wadelton, PLHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY5636 Issued in FL

Practice address

13000 Sawgrass Village Cir
Suite 46
Ponte Vedra Beach, FL 32082-5016

Phone

(904) 280-8555

Fax

(904) 280-8562

NPI assigned

Jan 11, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Transformative Healthcare Solutions IncGroup PAC ID 8921337973, 27 clinicians

Transformative Healthcare Solutions North LLCGroup PAC ID 7719417278, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Transformative Healthcare Solutions Inc

  • Clinical Psychologist
  • Fort Lauderdale, FL
  • NPI 1477114031
  Medicare reassignment Care Compare group NPD
• Transformative Healthcare Solutions North LLC

  • Clinical Psychologist
  • Jacksonville, FL
  • NPI 1205661337
  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932
  Medicare reassignment NPD
• Mental Health Center of Florida PA

  • Clinical Psychologist
  • Fort Lauderdale, FL
  • NPI 1679021414
  Medicare reassignment NPD
• Transformative Healthcare Solutions Central LLC

  • Clinical Psychologist
  • Orange City, FL
  • NPI 1407680002
  Medicare reassignment NPD
• Transformative Healthcare Solutions East LLC

  • Clinical Psychologist
  • Fort Lauderdale, FL
  • NPI 1861227993
  Medicare reassignment NPD
• Transformative Healthcare Solutions Gold Coast LLC

  • Clinical Psychologist
  • Fort Lauderdale, FL
  • NPI 1720814536
  Medicare reassignment NPD
• Transformative Healthcare Solutions South LLC

  • Clinical Psychologist
  • Fort Lauderdale, FL
  • NPI 1265265193
  Medicare reassignment NPD
• Transformative Healthcare Solutions West LLC

  • Clinical Psychologist
  • Tampa, FL
  • NPI 1700610508
  Medicare reassignment NPD
• Pro Performance Physical Therapy LLC

  • Physical Therapist
  • Fort Lauderdale, FL
  • NPI 1215598529
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083764039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 SAWGRASS VILLAGE CIR",
            "address_2": "SUITE 46",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320825016",
            "telephone_number": "904-280-8555",
            "fax_number": "904-280-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13000 SAWGRASS VILLAGE CIR",
            "address_2": "SUITE 46",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320825016",
            "telephone_number": "904-280-8555",
            "fax_number": "904-280-8562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADELTON",
        "first_name": "BAMBI",
        "middle_name": "LYNN",
        "credential": "PLHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY5636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vision Express
• Paul L Vitulli, DO
• Kyle Brendan Volland, PHARM.D.
• Stephanie Anne Voshell, HAS
• Janice Wachtel, PH.D.
• Susan Smicklas Wadsworth, OT
• Walgreen Co
• Claudette Narcisa Walker, ARNP
• Georganna Walker, OT
• Matthew Bryan Wander, ATC

• Clinical Psychologist in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.