Individual provider Active NPI

Jeffrey Scott Bedwell, PH.D.

  • Clinical Psychologist
  • Winter Park, FL
National Provider Identifier
1295950186
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 7264 Issued in FL
Practice address
1345 Clay St
Winter Park Anxiety Clinic
Winter Park, FL 32789-5404
Phone
(407) 416-0812
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 PY 7264 FL Primary

Addresses

Primary practice location

1345 Clay St
Winter Park Anxiety Clinic
Winter Park, FL 32789-5404

Mailing address

4000 Central Florida Blvd
Department of Psychology - University of Central FL
Orlando, FL 32816-1390
Phone (407) 823-5858

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY 7264FLMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295950186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 CENTRAL FLORIDA BLVD",
            "address_2": "DEPARTMENT OF PSYCHOLOGY - UNIVERSITY OF CENTRAL FL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328161390",
            "telephone_number": "407-823-5858",
            "fax_number": "407-823-5862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 CLAY ST",
            "address_2": "WINTER PARK ANXIETY CLINIC",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327895404",
            "telephone_number": "407-416-0812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDWELL",
        "first_name": "JEFFREY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 7264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.