Individual provider Active NPI

Gail J Purdy, PHD, BCBA

  • Clinical Psychologist
  • Homosassa, FL
National Provider Identifier
1174531420
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 5901 Issued in FL
Practice address
11842 W Waterway Dr
Homosassa, FL 34448-7312
Phone
(352) 628-7611
Fax
(352) 628-7644
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY 5901 FL
Cognitive & Behavioral Psychologist 103TB0200X
Clinical Psychologist 103TC0700X PY 5901 FL Primary
School Psychologist 103TS0200X

Addresses

Primary practice location

11842 W Waterway Dr
Homosassa, FL 34448-7312

Mailing address

11842 W Waterway Dr
Homosassa, FL 34448-7312
Phone (352) 628-7611

Other identifiers 1

IdentifierTypeStateIssuer
689827196MedicaidFL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050829000834 FL Practitioner - Clinical Psychologist 5496786402 Practice locations: Homosassa, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8546 W Homosassa TRL
Homosassa, FL 34448-2708
Phone (352) 628-7611

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY 5901FLMDClinical Psychologist

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1174531420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11842 W WATERWAY DR",
            "city": "HOMOSASSA",
            "state": "FL",
            "postal_code": "344487312",
            "telephone_number": "352-628-7611",
            "fax_number": "352-628-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11842 W WATERWAY DR",
            "city": "HOMOSASSA",
            "state": "FL",
            "postal_code": "344487312",
            "telephone_number": "352-628-7611",
            "fax_number": "352-628-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURDY",
        "first_name": "GAIL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHD, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY 5901",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 5901",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "689827196",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homosassa, FL

Sources for this page

Verify at the official NPI Registry.