Active NPI
Randall E Weeks, PHD
- Clinical Psychologist
- Stamford, CT
National Provider Identifier
1629150719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1043
- Practice address
- 30 Buxton Farms Road
Suite 230
Stamford, CT 06905 - Phone
- (203) 322-7639
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1043 | CT | Primary |
Addresses
Primary practice location
30 Buxton Farms Road
Suite 230
Stamford, CT 06905
Mailing address
30 Buxton Farms Road
Suite 230
Stamford, CT 06905
Phone (203) 322-7639
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061205000610 | CT | Practitioner - Clinical Psychologist | 1355340191 | Practice locations: Stamford, CT |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- University of North Texas HSC, College of Osteopathic Med, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
30 Buxton Farm Rd
Stamford, CT 06905-1206
Phone (203) 322-7639
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1043 | CT | MD | Clinical Psychologist |
| 001043 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206662400000",
"number": "1629150719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 BUXTON FARMS ROAD",
"address_2": "SUITE 230",
"city": "STAMFORD",
"state": "CT",
"postal_code": "06905",
"telephone_number": "203-322-7639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 BUXTON FARMS ROAD",
"address_2": "SUITE 230",
"city": "STAMFORD",
"state": "CT",
"postal_code": "06905",
"telephone_number": "203-322-7639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEEKS",
"first_name": "RANDALL",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2008-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "1043",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stamford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; 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.