Individual provider Active NPI

Stormi Lynne Pulver, PSYD

  • Psychologist
  • Atlanta, GA
National Provider Identifier
1265865687
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY004268 Issued in GA
Practice address
1920 Briarcliff Rd NE
Atlanta, GA 30329-4010
Phone
(404) 785-9400
Fax
(404) 785-9068
NPI assigned
Aug 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY004268 GA Primary

Addresses

Primary practice location

1920 Briarcliff Rd NE
Atlanta, GA 30329-4010

Mailing address

1920 Briarcliff Rd NE
Atlanta, GA 30329-4010
Phone (404) 785-9400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address choa@choa.gadirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY004268GAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Nov 1, 2013 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Nov 1, 2013 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 3

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": "1377043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1265865687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 BRIARCLIFF RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303294010",
            "telephone_number": "404-785-9400",
            "fax_number": "404-785-9068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 BRIARCLIFF RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303294010",
            "telephone_number": "404-785-9400",
            "fax_number": "404-785-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULVER",
        "first_name": "STORMI",
        "middle_name": "LYNNE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-21",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY004268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "1920 Briarcliff Rd NE",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303294010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.