Individual provider Active NPI

Patricia Studer, PSY.D.

  • Clinical Psychologist
  • Fayetteville, AR
National Provider Identifier
1215110861
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
07-35P Issued in AR
Practice address
280 S Hill Ave
A101
Fayetteville, AR 72701-5751
Phone
(479) 466-4503
NPI assigned
Dec 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

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 07-35P AR Primary

Addresses

Primary practice location

280 S Hill Ave
A101
Fayetteville, AR 72701-5751

Mailing address

280 S Hill Ave
A101
Fayetteville, AR 72701-5751
Phone (479) 466-4503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20081119000566 AR Practitioner - Clinical Psychologist 3971688524 Practice locations: Fayetteville, AR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

65 E Sunbridge Dr
Patricia Studer PSYD
Fayetteville, AR 72702-2894
Phone (479) 466-4503

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07-35PARMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Psychassociates LLP Clinical Past Accepting new patients
Ozark Guidance Center, Inc PastSince May 25, 2021 Accepting new patients

Organizations & group practices 2

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": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1215110861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 S HILL AVE",
            "address_2": "A101",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727015751",
            "telephone_number": "479-466-4503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 S HILL AVE",
            "address_2": "A101",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727015751",
            "telephone_number": "479-466-4503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUDER",
        "first_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-06",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "07-35P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.