Amy Justice

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P.5065 Issued in OH

Practice address

18660 Bagley Rd Ste 404
Middleburg Heights, OH 44130-3483

Phone

(440) 234-8746

Fax

(440) 234-8748

NPI assigned

Jul 2, 2021

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 OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Florence Kimbo M.D., LLC

  • Psychiatry Physician
  • Middleburg Heights, OH
  • NPI 1457788960
  Medicare reassignment

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

{
    "created_epoch": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1609447499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 163",
            "city": "LAKEMORE",
            "state": "OH",
            "postal_code": "442500163",
            "telephone_number": "330-802-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18660 BAGLEY RD STE 404",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303483",
            "telephone_number": "440-234-8746",
            "fax_number": "440-234-8748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-02",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "OH",
            "license": "P.5065",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "P.5065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Tyes Johnson, M. ED, LSC, LPC
• Erica Jones
• Erin Jones
• Dankesh Joshi
• Lucy Alia Jury, NP
• Ana Tereza Andrade Kabira, M.D.
• Victor Kairouz, M.D.
• Joshua Kaiser
• Cindy Kalogeras, QMHS
• Daniel Kana, D.O.

• Clinical Psychologist in Middleburg Heights, OH
• Providers in Middleburg Heights, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.