Individual provider Active NPI

Kathryn R Trumbo, PHD

  • Psychologist
  • Gainesville, FL
National Provider Identifier
1497122345
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY12169 Issued in FL
Practice address
4343 W Newberry Rd
Suite 2
Gainesville, FL 32607-2822
Phone
(352) 332-9441
Fax
(352) 331-6550
NPI assigned
Aug 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Psychologist 103T00000X PY12169 FL Primary

Addresses

Primary practice location

4343 W Newberry Rd
Suite 2
Gainesville, FL 32607-2822

Mailing address

4881 NW 8TH Ave
Suite 2
Gainesville, FL 32605-4582
Phone (352) 416-1082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240419000982 FL Practitioner - Clinical Psychologist 1153760467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Simedhealth LLCGroup PAC ID 6608137054, 89 clinicians

Practice addresses (Care Compare)

4343 W Newberry Rd
Gainesville, FL 32607-2817
Phone (352) 416-1082

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY12169FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Simed Health LLC CurrentSince Mar 11, 2024 Accepting new patients
Simedhealth LLC CurrentSince Mar 11, 2024 Accepting new patients

Locations

4343 Newberry Rd
Ste 2
Gainesville, FL 32607
Phone (352) 332-7246

4881 NW 8th Ave
Ste 2
Gainesville, FL 32605
Phone (352) 373-6338

4343 Newberry Rd
Gainesville, FL 32607
Phone (352) 224-2200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1497122345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 NW 8TH AVE",
            "address_2": "SUITE 2",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054582",
            "telephone_number": "352-416-1082",
            "fax_number": "352-373-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 W NEWBERRY RD",
            "address_2": "SUITE 2",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072822",
            "telephone_number": "352-332-9441",
            "fax_number": "352-331-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUMBO",
        "first_name": "KATHRYN",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-26",
        "last_updated": "2024-05-17",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY12169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.