Individual provider Active NPI

Andrew Koliani, PHD

  • Psychologist
  • Columbus, GA
National Provider Identifier
1588900062
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY003642 Issued in GA
Practice address
2325 Brookstone Centre Pkwy
Columbus, GA 31904-4500
Phone
(706) 653-6841
Fax
(706) 653-7843
NPI assigned
Jan 2, 2013
Last updated
Jan 2, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY003642 GA Primary

Addresses

Primary practice location

2325 Brookstone Centre Pkwy
Columbus, GA 31904-4500

Mailing address

2325 Brookstone Centre Pkwy
Columbus, GA 31904-4500
Phone (706) 653-6841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20130111000162 GA Practitioner - Clinical Psychologist 6709039266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbus Psychological Associates, LLPGroup PAC ID 8527054162, 12 clinicians

Practice addresses (Care Compare)

2325 Brookstone Centre Pkwy
Columbus, GA 31904-4500
Phone (706) 653-6841

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY003642GAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Psychological Associates, LLP Psychologist CurrentSince Jun 15, 2017 Accepting new patients
Columbus Psychological Assoc. PastSince Jan 2, 2013 Accepting new patients

Locations

2325 Brookstone Centre Pkwy
Columbus, GA 31904
Phone (706) 653-6841

3238 University Ave
Columbus, GA 31907
Phone (706) 563-1714

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, 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": "1357084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1588900062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 BROOKSTONE CENTRE PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319044500",
            "telephone_number": "706-653-6841",
            "fax_number": "706-653-7843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 BROOKSTONE CENTRE PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319044500",
            "telephone_number": "706-653-6841",
            "fax_number": "706-653-7843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLIANI",
        "first_name": "ANDREW",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-02",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY003642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.