Organization Active NPI

Mercedes Kamerman PSYD LLC

  • Psychologist
  • Dawsonville, GA
National Provider Identifier
1508579483
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MERCEDES KAMERMAN PSYD LLC
Doing business as
Psychological Services of North Georgia
Practice address
75 Elliott Rd Ste 220
Dawsonville, GA 30534-8904
Phone
(352) 857-2741
NPI assigned
Jan 5, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Authorized official

Name
Mercedes Kamerman, PSYDNPI 1487103834
Title
Psychologist
Phone
(706) 203-1503

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

75 Elliott Rd Ste 220
Dawsonville, GA 30534-8904

Mailing address

1585 Wyntercreek CT
Hoschton, GA 30548-3660
Phone (352) 857-2741

Other names 1

  • Psychological Services of North Georgia Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230310000263 GA Part B Supplier - Clinic/Group Practice 8820461957 Receives reassigned benefits from 2 practitioners
Practice locations: Dawsonville, GA

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1672876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1508579483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 WYNTERCREEK CT",
            "city": "HOSCHTON",
            "state": "GA",
            "postal_code": "305483660",
            "telephone_number": "352-857-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 ELLIOTT RD STE 220",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305348904",
            "telephone_number": "352-857-2741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCEDES KAMERMAN PSYD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-05",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A",
        "authorized_official_last_name": "KAMERMAN",
        "authorized_official_first_name": "MERCEDES",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "706-203-1503",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychological Services of North Georgia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dawsonville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.