Active NPI
Ron Jay Boney, PH.D.
- Clinical Psychologist
- Weatherford, TX
National Provider Identifier
1366552648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2-2627
- Practice address
- 804 Santa Fe Dr
Weatherford, TX 76086-6525 - Phone
- (817) 599-4781
- Fax
- (817) 599-7611
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2-2627 | TX | Primary |
Addresses
Primary practice location
804 Santa Fe Dr
Weatherford, TX 76086-6525
Mailing address
804 Santa Fe Dr Ste C
Weatherford, TX 76086-6525
Phone (817) 599-4781
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0976920-01 | Medicaid | TX | |
| 2046-01 | Other | TX | PACIFICARE |
| 000000BY09 | Other | TX | BLUECROSS BLUESHIELD |
| 282164 | Other | TX | VALUEOPTIONS |
| 0004367855 | Other | TX | AETNA PPO |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2-2627 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216944000000",
"number": "1366552648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 SANTA FE DR STE C",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "760866525",
"telephone_number": "817-599-4781",
"fax_number": "817-599-7611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "804 SANTA FE DR",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "760866525",
"telephone_number": "817-599-4781",
"fax_number": "817-599-7611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONEY",
"first_name": "RON",
"middle_name": "JAY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2008-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "2-2627",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0976920-01",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACIFICARE",
"identifier": "2046-01",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "000000BY09",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUEOPTIONS",
"identifier": "282164",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "0004367855",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Weatherford, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.