Individual provider Active NPI

Catherine Anne Yeager, PH.D

  • Clinical Psychologist
  • Fort Gordon, GA
National Provider Identifier
1427174424
Registry record updated Oct 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35S100475200 Issued in NJ
Practice address
300 E Hospital Road
Eisenhower Army Medical Center
Fort Gordon, GA 30905-5741
Phone
(706) 787-5623
NPI assigned
Mar 21, 2007
Last updated
Oct 10, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2013

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging Psychologist 103TA0700X 35S100475200 NJ
Cognitive & Behavioral Psychologist 103TB0200X 35S100475200 NJ
Clinical Psychologist 103TC0700X 35S100475200 NJ Primary
Clinical Child & Adolescent Psychologist 103TC2200X 35S100475200 NJ
Health Psychologist 103TH0004X 35S100475200 NJ

Addresses

Primary practice location

300 E Hospital Road
Eisenhower Army Medical Center
Fort Gordon, GA 30905-5741

Mailing address

300 E Hospital Road
Eisenhower Army Medical Center
Fort Gordon, GA 30905-5741
Phone (706) 787-5623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20140820001308 GA Order and Referring Only - Clinical Psychologist 6901024744

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35S100475200NJMDAdult Development & Aging Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1427174424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E HOSPITAL ROAD",
            "address_2": "EISENHOWER ARMY MEDICAL CENTER",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "706-787-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E HOSPITAL ROAD",
            "address_2": "EISENHOWER ARMY MEDICAL CENTER",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "706-787-5623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEAGER",
        "first_name": "CATHERINE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NJ",
            "license": "35S100475200",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NJ",
            "license": "35S100475200",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35S100475200",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NJ",
            "license": "35S100475200",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "NJ",
            "license": "35S100475200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gordon, GA

Sources for this page

Verify at the official NPI Registry.