Active NPI
Ansel L Woldt, ED.D.
- Psychologist
- Kent, OH
National Provider Identifier
1467542878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 982
- Practice address
- 511 Beryl Dr
Kent, OH 44240-4403 - Phone
- (330) 673-8729
- NPI assigned
- Oct 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 982 | OH | Primary |
Addresses
Primary practice location
511 Beryl Dr
Kent, OH 44240-4403
Mailing address
PO Box 770502
Lakewood, OH 44107-0027
Phone (216) 251-0505
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0948078 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100720000749 | OH | Practitioner - Clinical Psychologist | 4183756539 | Practice locations: Kent, OH |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- University of North Dakota School of Medicine, 1968
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
511 Beryl Dr
Kent, OH 44240-4403
Phone (330) 673-8729
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348444800000",
"number": "1467542878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 770502",
"city": "LAKEWOOD",
"state": "OH",
"postal_code": "441070027",
"telephone_number": "216-251-0505",
"fax_number": "216-251-0508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "511 BERYL DR",
"city": "KENT",
"state": "OH",
"postal_code": "442404403",
"telephone_number": "330-673-8729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLDT",
"first_name": "ANSEL",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-14",
"last_updated": "2012-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "982",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0948078",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kent, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.