Active NPI
Raymond Annable, PSY.D.
- Psychologist
- Wilmington, NC
National Provider Identifier
1093048241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4382
- Practice address
- 311 Judges Rd Ste 4E
Wilmington, NC 28405-3655 - Phone
- (910) 791-6767
- Fax
- (910) 791-6890
- NPI assigned
- Sep 4, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4382 | NC | Primary |
| Clinical Psychologist | 103TC0700X | 2078 | OR |
Addresses
Primary practice location
311 Judges Rd Ste 4E
Wilmington, NC 28405-3655
Mailing address
311 Judges Rd Ste 4E
Wilmington, NC 28405-3655
Phone (910) 791-6767
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4382 | NC | MD | Professional Counselor |
| 2078 | OR | MD | Naturopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357171200000",
"number": "1093048241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 JUDGES RD STE 4E",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284053655",
"telephone_number": "910-791-6767",
"fax_number": "910-791-6890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 JUDGES RD STE 4E",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284053655",
"telephone_number": "910-791-6767",
"fax_number": "910-791-6890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANNABLE",
"first_name": "RAYMOND",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-09-04",
"last_updated": "2013-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "4382",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "2078",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.