Individual provider Active NPI

Frank G. Stanley, PH.D.

  • Clinical Psychologist
  • Jacksonville, FL
National Provider Identifier
1497799696
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY0003949 Issued in FL
Practice address
6545 Bowden Rd
Jacksonville, FL 32216-6149
Phone
(904) 448-0079
Fax
(904) 636-9661
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY0003949 FL Primary

Addresses

Primary practice location

6545 Bowden Rd
Jacksonville, FL 32216-6149

Mailing address

6545 Bowden Rd
Jacksonville, FL 32216-6149
Phone (904) 448-0079

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
I20071207000093 FL Practitioner - Clinical Psychologist 9739073453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6545 Bowden Rd
Jacksonville, FL 32216-6149
Phone (904) 448-0079

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY0003949FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical & Health Psychology CurrentSince Oct 30, 2007 Accepting new patients

Locations

6545 Bowden Rd
Jacksonville, FL 32216
Phone (904) 448-0079

Organizations & group practices 1

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1497799696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 BOWDEN RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166149",
            "telephone_number": "904-448-0079",
            "fax_number": "904-636-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 BOWDEN RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166149",
            "telephone_number": "904-448-0079",
            "fax_number": "904-636-9661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "FRANK",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY0003949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.