Individual provider Active NPI

Jeffrey A Drury, PHD

  • Clinical Psychologist
  • Maysville, KY
National Provider Identifier
1093740557
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
129499 Issued in KY
Practice address
611 Forest Ave
Maysville, KY 41056-1411
Phone
(606) 564-4016
Fax
(606) 564-8288
NPI assigned
Jul 12, 2006
Last updated
Apr 30, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2019

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 129499 KY Primary

Addresses

Primary practice location

611 Forest Ave
Maysville, KY 41056-1411

Mailing address

611 Forest Ave
Maysville, KY 41056-1411
Phone (606) 564-4016

Other identifiers 1

IdentifierTypeStateIssuer
7100286130MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20130205000314 KY Practitioner - Clinical Psychologist 8921252628 Reassigns benefits to 1 organization

National Provider Directory

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1093740557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 FOREST AVE",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410561411",
            "telephone_number": "606-564-4016",
            "fax_number": "606-564-8288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 FOREST AVE",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410561411",
            "telephone_number": "606-564-4016",
            "fax_number": "606-564-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRURY",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "129499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100286130",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maysville, KY

Sources for this page

Verify at the official NPI Registry.