Ashley Kennedy Ibbotson, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

38123 Issued in TX

Practice address

604 Strada Cir
Mansfield, TX 76063-3201

Phone

(817) 453-2400

NPI assigned

Aug 29, 2017

Last updated

May 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seema Kazi MD PAGroup PAC ID 5193040772, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Seema Kazi MD PA

  dba Mid Cities Psychiatry

  • Psychiatry Physician
  • Euless, TX
  • NPI 1023423514
  Medicare reassignment Care Compare group NPD
• The Jones Center for Children's Therapy and Assessment

  • Clinical Child & Adolescent Psychologist
  • Mansfield, TX
  • NPI 1447534565
  NPD (past)

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1508383589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 STRADA CIR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633201",
            "telephone_number": "817-453-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 STRADA CIR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633201",
            "telephone_number": "817-453-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBBOTSON",
        "first_name": "ASHLEY",
        "middle_name": "KENNEDY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-29",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "38123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tony Hunt, LPC
• Meagan Hurst
• Hussey & Perkins, Inc. (BrightStar of Fort Worth-Burleson)
• I535 Family Healthcare
• Vivian Ibarra, RBT
• Joella Ibe
• Id Partners PA
• Oluchukwu Anne Ifele, APRN-CNP
• Boladale Igbekoyi
• Olugbemiga Igbekoyi

• Clinical Psychologist in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; 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.

Verify at the official NPI Registry.