Organization Active NPI

Affiliated Psychological & Medical Consultants, LLC

  • Psychologist
  • Gainesville, GA
National Provider Identifier
1174601348
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
AFFILIATED PSYCHOLOGICAL & MEDICAL CONSULTANTS, LLC
Practice address
200 W Academy Street NW
Suite a
Gainesville, GA 30501-8524
Phone
(770) 535-1284
Fax
(770) 536-3888
NPI assigned
Nov 2, 2006
Last updated
May 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Authorized official

Name
Ms. Luann B Woods
Title
Office Manager
Phone
(678) 630-4963

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X

Addresses

Primary practice location

200 W Academy Street NW
Suite a
Gainesville, GA 30501-8524

Mailing address

200 W Academy NW
Ste a
Gainesville, GA 30501-8524
Phone (770) 535-1284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040604000070 GA Part B Supplier - Clinic/Group Practice 1153303987 Receives reassigned benefits from 3 practitioners
Practice locations: Gainesville, GA

National Provider Directory

National Provider Directory

Locations

200 W Academy St NW
Ste A
Gainesville, GA 30501
Phone (770) 535-1284

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652745600000",
    "number": "1174601348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ACADEMY NW",
            "address_2": "STE A",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305018524",
            "telephone_number": "770-535-1284",
            "fax_number": "770-536-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ACADEMY STREET NW",
            "address_2": "SUITE A",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305018524",
            "telephone_number": "770-535-1284",
            "fax_number": "770-536-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFILIATED PSYCHOLOGICAL & MEDICAL CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "LUANN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "678-630-4963",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.