NPIMap

Organization Active NPI

Pediatric Psychological Associates PLLC

  • Clinical Psychologist
  • Louisville, KY
National Provider Identifier
1164435541
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
PEDIATRIC PSYCHOLOGICAL ASSOCIATES PLLC
Practice address
9700 Park Plaza Ave
Suite 106
Louisville, KY 40241-2236
Phone
(502) 429-5431
Fax
(502) 429-5495
NPI assigned
Aug 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kelly L. McGraw, PSYD
Title
Owner/Physician
Phone
(502) 429-5431

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

9700 Park Plaza Ave
Suite 106
Louisville, KY 40241-2236

Mailing address

9700 Park Plaza Ave
Suite 106
Louisville, KY 40241-2236
Phone (502) 429-5431

National Provider Directory

National Provider Directory

Locations

9700 Park Plaza Ave
Unit 106
Louisville, KY 40241
Phone (502) 429-5431

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164435541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 PARK PLAZA AVE",
            "address_2": "SUITE 106",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402412236",
            "telephone_number": "502-429-5431",
            "fax_number": "502-429-5495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9700 PARK PLAZA AVE",
            "address_2": "SUITE 106",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402412236",
            "telephone_number": "502-429-5431",
            "fax_number": "502-429-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PSYCHOLOGICAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCGRAW",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "502-429-5431",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.