Individual provider Active NPI

Nolan Katz, PHD

  • School Psychologist
  • Fort Myers, FL
National Provider Identifier
1356633671
Registry record updated Sep 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
SS 1067 Issued in FL
Practice address
12791 World Plaza LN BLDG 89
Fort Myers, FL 33907-3989
Phone
(239) 247-1756
Fax
(239) 690-2438
NPI assigned
May 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X SS 1067 FL Primary

Addresses

Primary practice location

12791 World Plaza LN BLDG 89
Fort Myers, FL 33907-3989

Mailing address

12791 World Plaza LN BLDG 89
Fort Myers, FL 33907-3989
Phone (239) 247-1756

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
I20110824000048 FL Practitioner - Clinical Psychologist 9638349921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12641 World Plaza Lane
BLDG. 56
Fort Myers, FL 33907-3989
Phone (239) 247-1756

12791 World Plaza Lane
Fort Myers, FL 33907-3989

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SS 1067FLMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Katz Counseling and Educational Psychology School CurrentSince May 18, 2011 Accepting new patients
Fort Myers Psychology, PA PastSince Jun 29, 2006 Accepting new patients

Locations

12791 World Plaza Ln
Bldg 89
Fort Myers, FL 33907
Phone (239) 247-1756

12641 World Plaza Ln
Bldg 56
Fort Myers, FL 33907
Phone (239) 247-1756

Organizations & group practices 2

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": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1356633671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12791 WORLD PLAZA LN BLDG 89",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073989",
            "telephone_number": "239-247-1756",
            "fax_number": "239-690-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12791 WORLD PLAZA LN BLDG 89",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073989",
            "telephone_number": "239-247-1756",
            "fax_number": "239-690-2438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "NOLAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-04",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "FL",
            "license": "SS 1067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.