Active NPI
Deborah Jean Taylor, PSY.D.
- Psychologist
- Hampstead, NC
National Provider Identifier
1366408718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2791
- Practice address
- 15444 US Hwy. 17 N
BLDG. 16
Hampstead, NC 28443-8250 - Phone
- (910) 270-5505
- Fax
- (910) 270-5496
- NPI assigned
- Apr 25, 2006
- Last updated
- Jun 6, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2791 | NC | Primary |
Addresses
Primary practice location
15444 US Hwy. 17 N
BLDG. 16
Hampstead, NC 28443-8250
Mailing address
5010 Randall Parkway
Wilmington, NC 28403-2829
Phone (910) 791-5719
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6000851 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060427000669 | NC | Practitioner - Clinical Psychologist | 6103836697 | Practice locations: Wilmington, NC |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
3205 Randall Pkwy
Suite 118
Wilmington, NC 28403-2567
Phone (910) 769-3660
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2791 | NC | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307318400000",
"number": "1366408718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5010 RANDALL PARKWAY",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284032829",
"telephone_number": "910-791-5719",
"fax_number": "910-799-8180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15444 US HWY. 17 N",
"address_2": "BLDG. 16",
"city": "HAMPSTEAD",
"state": "NC",
"postal_code": "284438250",
"telephone_number": "910-270-5505",
"fax_number": "910-270-5496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "DEBORAH",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-25",
"last_updated": "2011-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "2791",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6000851",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hampstead, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.