Individual provider Active NPI

James R Kinney Jr., PSY.D.

  • Clinical Child & Adolescent Psychologist
  • Dunedin, FL
National Provider Identifier
1245587831
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PY 9042 Issued in FL
Practice address
2275 Highwood CT
Dunedin, FL 34698-6318
Phone
(727) 463-2843
Fax
(727) 784-1890
NPI assigned
Aug 14, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X PY 9042 FL
Clinical Psychologist 103TC0700X PY 9042 FL
Psychologist 103T00000X PY 9042 FL
Counseling Psychologist 103TC1900X PY 9042 FL
Family Psychologist 103TF0000X PY 9042 FL
Clinical Child & Adolescent Psychologist 103TC2200X PY 9042 FL Primary

Addresses

Primary practice location

2275 Highwood CT
Dunedin, FL 34698-6318

Mailing address

2410 Northside Dr
Clearwater, FL 33761-2236
Phone (727) 499-0351

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
I20150206001329 FL Practitioner - Clinical Psychologist 7012232465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2275 Highwood CT
Dunedin, FL 34698-6318
Phone (727) 463-2863

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY 9042FLMDFamily Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
James R. Kinney Jr., Psy.D., P.L.L.C. Psychologist CurrentSince Sep 15, 2014 Accepting new patients

Locations

2410 Northside Dr
Clearwater, FL 33761
Phone (727) 499-0358

10225 Ulmerton Rd
Ste 1A
Largo, FL 33771
Phone (727) 585-7408

Networks

  • Freedom Health HMO Network

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": "1344902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1245587831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 NORTHSIDE DR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337612236",
            "telephone_number": "727-499-0351",
            "fax_number": "727-223-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 HIGHWOOD CT",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346986318",
            "telephone_number": "727-463-2843",
            "fax_number": "727-784-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNEY",
        "first_name": "JAMES",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-14",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "FL",
            "license": "PY 9042",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 9042",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY 9042",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY 9042",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "FL",
            "license": "PY 9042",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY 9042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunedin, FL

Sources for this page

Verify at the official NPI Registry.