Individual provider Active NPI

Ronald C Yarbrough, PH.D.

  • Clinical Psychologist
  • Pensacola, FL
National Provider Identifier
1376544684
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY2717 Issued in FL
Practice address
1576 Airport Blvd
Pensacola, FL 32504-8616
Phone
(850) 478-3888
Fax
(850) 478-0914
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY2717 FL Primary

Addresses

Primary practice location

1576 Airport Blvd
Pensacola, FL 32504-8616

Mailing address

1576 Airport Blvd
Pensacola, FL 32504-8616
Phone (850) 478-3888

Other identifiers 2

IdentifierTypeStateIssuer
103TC0700XOtherFLTAXONOMY MUMBER
PY2717OtherFLSTATE LICENSE INFORMATION

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
I20101210000626 FL Practitioner - Clinical Psychologist 1355538737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1576 Airport Blvd
Pensacola, FL 32504-8616

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY2717FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ronald C. Yarbrough, PH.D., P.a. Clinical CurrentSince Oct 14, 2010 Accepting new patients

Locations

1576 Airport Blvd
Pensacola, FL 32504
Phone (703) 203-0490

Organizations & group practices 1

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1376544684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1576 AIRPORT BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048616",
            "telephone_number": "850-478-3888",
            "fax_number": "850-478-0914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1576 AIRPORT BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048616",
            "telephone_number": "850-478-3888",
            "fax_number": "850-478-0914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARBROUGH",
        "first_name": "RONALD",
        "middle_name": "C",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY2717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY MUMBER",
            "identifier": "103TC0700X",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE INFORMATION",
            "identifier": "PY2717",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.