Active NPI
Andrea Omidy, PHD
- Clinical Psychologist
- Lexington, KY
National Provider Identifier
1285911719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1749
- Practice address
- 715 Shaker Dr
Suite 132
Lexington, KY 40504-3662 - Phone
- (859) 913-4825
- NPI assigned
- Nov 11, 2011
- Last updated
- Apr 10, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 1749 | KY | |
| Clinical Psychologist | 103TC0700X | 1749 | KY | Primary |
| Counseling Psychologist | 103TC1900X | 1749 | KY | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 1749 | KY | |
| Family Psychologist | 103TF0000X | 1749 | KY | |
| Group Psychotherapy Psychologist | 103TP2701X | 1749 | KY | |
| Health Psychologist | 103TH0004X | 1749 | KY |
Addresses
Primary practice location
715 Shaker Dr
Suite 132
Lexington, KY 40504-3662
Mailing address
715 Shaker Dr
Suite 132
Lexington, KY 40504-3662
Phone (859) 913-4825
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1749 | KY | MD | Health Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397088000000",
"number": "1285911719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 SHAKER DR",
"address_2": "SUITE 132",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405043662",
"telephone_number": "859-913-4825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 SHAKER DR",
"address_2": "SUITE 132",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405043662",
"telephone_number": "859-913-4825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OMIDY",
"first_name": "ANDREA",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-11",
"last_updated": "2014-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "KY",
"license": "1749",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KY",
"license": "1749",
"primary": true
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "KY",
"license": "1749",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "KY",
"license": "1749",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "KY",
"license": "1749",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "KY",
"license": "1749",
"primary": false
},
{
"code": "103TH0004X",
"taxonomy_group": "",
"desc": "Psychologist, Health",
"state": "KY",
"license": "1749",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.