Individual provider Active NPI

Robin Ann Avery, PH.D.

  • Clinical Neuropsychologist
  • Miami Shores, FL
National Provider Identifier
1407263999
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY8768 Issued in FL
Practice address
9999 NE 2ND Ave
Suite 209, E
Miami Shores, FL 33138-2352
Phone
(786) 615-4758
NPI assigned
Jul 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY8768 FL
Clinical Psychologist 103TC0700X PY8768 FL
Clinical Neuropsychologist 103G00000X PY8768 FL Primary

Addresses

Primary practice location

9999 NE 2ND Ave
Suite 209, E
Miami Shores, FL 33138-2352

Mailing address

9999 NE 2ND Ave
Suite 209, E
Miami Shores, FL 33138-2352
Phone (786) 615-4758

Other identifiers 1

IdentifierTypeStateIssuer
00000OtherFLDO NOT HAVE ANY NUMBER AT THIS TIME

Other names 1

  • Dr. Robin A Avery Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141006002245 FL Practitioner - Clinical Psychologist 8729208152 Reassigns benefits to 2 organizations
I20210219000734 NC Practitioner - Clinical Psychologist 8729208152 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Larry Brooks, PH.D., LLCGroup PAC ID 6608028899, 2 clinicians

Practice addresses (Care Compare)

10 Glen Cove Dr
Arden, NC 28704-3207
Phone (305) 992-0370

3810 Hollywood Blvd
Suite 2
Hollywood, FL 33021-6779
Phone (954) 962-3888

9999 NE 2ND Ave
Suite 209E
Miami Shores, FL 33138-2345
Phone (786) 615-4758

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY8768FLMDPsychologist
5824NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Larry Brooks, PH.D., LLC Clinical Neuropsychologist CurrentSince Jul 19, 2022 Accepting new patients
The Pisgah Institute for Psychotherapy & Education, P.a. Psychologist CurrentSince Mar 15, 2021 Accepting new patients

Locations

3810 Hollywood Blvd
Ste 2
Hollywood, FL 33021
Phone (954) 962-3888

158 Zillicoa St
Asheville, NC 28801
Phone (828) 254-9494

Organizations & group practices 3

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": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1407263999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9999 NE 2ND AVE",
            "address_2": "SUITE 209, E",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331382352",
            "telephone_number": "786-615-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9999 NE 2ND AVE",
            "address_2": "SUITE 209, E",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331382352",
            "telephone_number": "786-615-4758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERY",
        "first_name": "ROBIN",
        "middle_name": "ANN",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-16",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY8768",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8768",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY8768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DO NOT HAVE ANY NUMBER AT THIS TIME",
            "identifier": "00000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBIN",
            "last_name": "AVERY",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Miami Shores, FL

Sources for this page

Verify at the official NPI Registry.