NPIMap

Organization Active NPI

Susan R King PSYD PA

  • Psychologist
  • Fort Myers, FL
National Provider Identifier
1356539175
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0701501 Issued in FL
Legal business name
SUSAN R KING PSYD PA
Practice address
5245 Ramsey Way Ste 1
Fort Myers, FL 33907-2124
Phone
(239) 929-0274
Fax
(239) 437-5913
NPI assigned
Oct 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Authorized official

Name
Susan R King, PSY D PANPI 1013093624
Title
Psychologist
Phone
(239) 929-0274

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 0701501 FL Primary

Addresses

Primary practice location

5245 Ramsey Way Ste 1
Fort Myers, FL 33907-2124

Mailing address

5245 Ramsey Way Ste 1
Fort Myers, FL 33907-2124
Phone (239) 929-0274

National Provider Directory

National Provider Directory

Locations

5235 Ramsey Way
Ste D1
Fort Myers, FL 33907
Phone (239) 939-0274

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1356539175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5245 RAMSEY WAY STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339072124",
            "telephone_number": "239-929-0274",
            "fax_number": "239-437-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5245 RAMSEY WAY STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339072124",
            "telephone_number": "239-929-0274",
            "fax_number": "239-437-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN R KING PSYD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "239-929-0274",
        "authorized_official_credential": "PSY D PA"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "0701501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.