Individual provider Active NPI

Deborah Jean Taylor, PSY.D.

  • Psychologist
  • Hampstead, NC
National Provider Identifier
1366408718
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2791 Issued in NC
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, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
6000851MedicaidNC

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
2791NCMDOccupational 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

Verify at the official NPI Registry.