Individual provider Active NPI

James Allan Purvis, PH.D.

  • Psychologist
  • Cumming, GA
National Provider Identifier
1215097894
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1491 Issued in GA
Practice address
5807 Long Park Rd
Cumming, GA 30040-5718
Phone
(470) 508-8955
Fax
(470) 508-8956
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 1491 GA
Psychologist 103T00000X 1491 GA Primary

Addresses

Primary practice location

5807 Long Park Rd
Cumming, GA 30040-5718

Mailing address

PO Box 5907
Alpharetta, GA 30023-5907
Phone (470) 508-8955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20050817000876 GA Practitioner - Clinical Psychologist 1254361488 Practice locations: Cumming, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5807 Long Park Rd
Cumming, GA 30040-5718
Phone (470) 508-8955

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1491GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Robin a. Brill, PHD,LLC PastSince Mar 28, 2021 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1215097894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5907",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300235907",
            "telephone_number": "470-508-8955",
            "fax_number": "470-508-8956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5807 LONG PARK RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300405718",
            "telephone_number": "470-508-8955",
            "fax_number": "470-508-8956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURVIS",
        "first_name": "JAMES",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "GA",
            "license": "1491",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "1491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.