Individual provider Active NPI

Ronald R. Hart, PH.D.

  • Clinical Neuropsychologist
  • St Simons Island, GA
National Provider Identifier
1598749160
Registry record updated Sep 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY001838 Issued in GA
Practice address
1624 Frederica Road
Suite 3
Saint Simons Island, GA 31522-2506
Phone
(912) 634-1677
Fax
(912) 634-1677
NPI assigned
Dec 6, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2007

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY001838 GA Primary
Psychologist 103T00000X PSY001838 GA
Adult Development & Aging Psychologist 103TA0700X PSY001838 GA
Cognitive & Behavioral Psychologist 103TB0200X PSY001838 GA
Clinical Psychologist 103TC0700X PSY001838 GA
Counseling Psychologist 103TC1900X PSY001838 GA
Health Psychologist 103TH0004X PSY001838 GA
Health Service Psychologist 103TH0100X PSY001838 GA
Group Psychotherapy Psychologist 103TP2701X PSY001838 GA
Rehabilitation Psychologist 103TR0400X PSY001838 GA

Addresses

Primary practice location

1624 Frederica Road
Suite 3
Saint Simons Island, GA 31522-2506

Mailing address

1624 Frederica Road
Suite 3
Saint Simons Island, GA 31522-2506
Phone (912) 634-1677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY001838GAMDAdult Development & Aging Psychologist
1838GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Health Services, Inc. Clinical Neuropsychologist Past Accepting new patients

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": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1598749160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 FREDERICA ROAD",
            "address_2": "SUITE 3",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222506",
            "telephone_number": "912-634-1677",
            "fax_number": "912-634-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 FREDERICA ROAD",
            "address_2": "SUITE 3",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222506",
            "telephone_number": "912-634-1677",
            "fax_number": "912-634-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "RONALD",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "GA",
            "license": "PSY001838",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY001838",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "GA",
            "license": "PSY001838",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "GA",
            "license": "PSY001838",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY001838",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "GA",
            "license": "PSY001838",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "GA",
            "license": "PSY001838",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "GA",
            "license": "PSY001838",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "GA",
            "license": "PSY001838",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "GA",
            "license": "PSY001838",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Simons Island, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.