Individual provider Active NPI

G Rita Dudley Grant, PHD

  • Psychologist
  • Christiansted, VI
National Provider Identifier
1497870638
Registry record updated Jul 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
98007PSY Issued in VI
Practice address
5030 Anchor Way Ste 9&10
Christiansted, VI 00820
Phone
(340) 719-7007
NPI assigned
Mar 20, 2007
Last updated
Jul 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 98007PSY VI Primary

Addresses

Primary practice location

5030 Anchor Way Ste 9&10
Christiansted, VI 00820

Mailing address

PO Box 24241
Christiansted, VI 00824
Phone (340) 773-6445

Other practice location 1

40 EG La Grange
Frederiksted, VI 00840
Phone (340) 773-6445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VI
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
I20180815002496 VI Practitioner - Clinical Psychologist 8628327269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lindsy Wagner LLCGroup PAC ID 3476800574, 16 clinicians

Practice addresses (Care Compare)

5030 Anchor Way
Christiansted, VI 00820-4692
Phone (340) 719-7007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
98007PSYVIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lindsy Wagner LLC CurrentSince Mar 22, 2018 Accepting new patients

Locations

5030 Anchor Way
Ste 7
Christiansted, VI 00820
Phone (973) 280-4006

5030 Anchor Way
Ste 910
Christiansted, VI 00820
Phone (340) 277-8924

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, 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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532649600000",
    "number": "1497870638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24241",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "00824",
            "telephone_number": "340-773-6445",
            "fax_number": "340-773-3389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 ANCHOR WAY STE 9&10",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "00820",
            "telephone_number": "340-719-7007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 EG La Grange",
            "address_purpose": "LOCATION",
            "city": "Frederiksted",
            "state": "VI",
            "postal_code": "00840",
            "country_code": "US",
            "telephone_number": "340-773-6445",
            "fax_number": "340-773-3389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUDLEY GRANT",
        "first_name": "G RITA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2018-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VI",
            "license": "98007PSY",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Christiansted, VI

Sources for this page

Verify at the official NPI Registry.