Audrey Nicole Atkinson, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4510 Issued in NC

Practice address

903 Northeast Dr Ste 102
Davidson, NC 28036-7437

Phone

(980) 221-2113

NPI assigned

Mar 27, 2012

Last updated

Oct 16, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 16, 2019 through Sep 16, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508112000000",
    "number": "1417223124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 NORTHEAST DR STE 102",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280367437",
            "telephone_number": "980-221-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 NORTHEAST DR STE 102",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280367437",
            "telephone_number": "980-221-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATKINSON",
        "first_name": "AUDREY",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-27",
        "last_updated": "2017-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "4510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prakasam Annamalai, RDN
• Scott Michael Applegate, A.T.C.
• Jessica Thuy-Mai Arnett, PA-C
• Melissa D Arrington, PHARMD
• Yordan Ascanio
• Jonathan Atkinson, LMFTA
• Atlantic HLTH Resources Inc
• Brian Bache, RPH
• Balanced Choices, PLLC
• Heather Elizabeth Banks-Blackburn, MA, RD, LDN

• Clinical Psychologist in Davidson, NC
• Providers in Davidson, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2017; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.