Micah J Price, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY8255 Issued in FL

Practice address

307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302

Phone

(954) 667-3628

NPI assigned

Mar 19, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1300492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1427357292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD STE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD STE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421302",
            "telephone_number": "954-667-3628"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Snug Harbour Dr",
            "address_purpose": "LOCATION",
            "city": "Shalimar",
            "state": "FL",
            "postal_code": "325791261",
            "country_code": "US",
            "telephone_number": "954-667-3628",
            "fax_number": "413-280-4105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRICE",
        "first_name": "MICAH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-19",
        "last_updated": "2022-07-21",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY8255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Pope, IDMT
• Boden James Port, DO
• Jayce Porter, D.O.
• Dylan Preister, IDMT
• Crystal Earl Price, PHARMD
• Lewis Pulley
• Joe Lynn Purvis, LCSW
• Lisa Darbonne Rackley, DDS
• Amanda Eitel Ramsey, IDMT
• Ronald Rasor, M.D.

• Psychologist in Eglin Afb, FL
• Providers in Eglin Afb, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.