Individual provider Active NPI

Richard E Nay, PHD

  • Clinical Psychologist
  • Jacksonville, FL
National Provider Identifier
1295725034
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY0004562 Issued in FL
Practice address
2970 Hartley Rd
Ste 201
Jacksonville, FL 32257-8227
Phone
(904) 886-4998
Fax
(904) 292-1094
NPI assigned
Oct 24, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

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 PY0004562 FL Primary

Addresses

Primary practice location

2970 Hartley Rd
Ste 201
Jacksonville, FL 32257-8227

Mailing address

PO Box 23040
Jacksonville, FL 32241-3040
Phone (904) 886-4998

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
I20161018000456 FL Practitioner - Clinical Psychologist 2668465105 Reassigns benefits to 1 organization

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)

2970 Hartley Rd
Jacksonville, FL 32257-6245
Phone (904) 886-4998

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY0004562FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Richard E. Nay PHD Inc Clinical CurrentSince May 1, 2002 Accepting new patients

Locations

2970 Hartley Rd
Ste 201
Jacksonville, FL 32257
Phone (904) 268-7733

10232 San Jose Blvd
Jacksonville, FL 32257
Phone (904) 292-3700

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1295725034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23040",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322413040",
            "telephone_number": "904-886-4998",
            "fax_number": "904-292-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2970 HARTLEY RD",
            "address_2": "STE 201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578227",
            "telephone_number": "904-886-4998",
            "fax_number": "904-292-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAY",
        "first_name": "RICHARD",
        "middle_name": "E",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY0004562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.