Individual provider Active NPI

Mercedes Kamerman, PSYD

  • Psychologist
  • Dawsonville, GA
National Provider Identifier
1487103834
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY004052 Issued in GA
Practice address
75 Elliott Rd
Dawsonville, GA 30534-8901
Phone
(706) 203-1503
Fax
(706) 203-1504
NPI assigned
Sep 27, 2016
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY004052 GA Primary

Addresses

Primary practice location

75 Elliott Rd
Dawsonville, GA 30534-8901

Mailing address

75 Elliott Rd Ste 220
Dawsonville, GA 30534-8904
Phone (706) 203-1503

Other practice location 1

4073 Highway 53
Hoschton, GA 30548-2305
Phone (770) 882-5884

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
I20161201000730 GA Practitioner - Clinical Psychologist 1052691490 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercedes Kamerman PSYD LLCGroup PAC ID 8820461957, 2 clinicians

Practice addresses (Care Compare)

75 Elliott Rd
Suite 220
Dawsonville, GA 30534-8904
Phone (706) 203-1503

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Psychological Services LLC CurrentSince Oct 14, 2016 Accepting new patients
Mercedes Kamerman PSYD LLC Psychologist CurrentSince Feb 1, 2023 Accepting new patients

Locations

75 Elliott Rd
Ste 220
Dawsonville, GA 30534
Phone (352) 857-2741

4073 Highway 53
Hoschton, GA 30548
Phone (770) 882-5884

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1487103834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 ELLIOTT RD STE 220",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305348904",
            "telephone_number": "706-203-1503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 ELLIOTT RD",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305348901",
            "telephone_number": "706-203-1503",
            "fax_number": "706-203-1504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4073 Highway 53",
            "address_purpose": "LOCATION",
            "city": "Hoschton",
            "state": "GA",
            "postal_code": "305482305",
            "country_code": "US",
            "telephone_number": "770-882-5884",
            "fax_number": "706-658-0116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMERMAN",
        "first_name": "MERCEDES",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-27",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY004052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dawsonville, GA

Sources for this page

Verify at the official NPI Registry.