Active NPI
Anne Boone, PSY.D.
- Clinical Psychologist
- Durham, NC
National Provider Identifier
1649352824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2825
- Practice address
- 3622 Lyckan Pkwy
Suite 4003
Durham, NC 27707-2564 - Phone
- (919) 627-8442
- NPI assigned
- Oct 19, 2006
- Last updated
- Sep 27, 2010
- Sex
- Female
- 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 | 2825 | NC | Primary |
Addresses
Primary practice location
3622 Lyckan Pkwy
Suite 4003
Durham, NC 27707-2564
Mailing address
3622 Lyckan Pkwy
Suite 4003
Durham, NC 27707-2564
Phone (919) 627-8442
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6000866 | Medicaid | NC | |
| 2290464 | Other | NC | CIGNA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2825 | NC | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cohesive Pathways, PC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
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- Chapel Hill, NC
- NPI 1003034547
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": "1285545600000",
"number": "1649352824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3622 LYCKAN PKWY",
"address_2": "SUITE 4003",
"city": "DURHAM",
"state": "NC",
"postal_code": "277072564",
"telephone_number": "919-627-8442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3622 LYCKAN PKWY",
"address_2": "SUITE 4003",
"city": "DURHAM",
"state": "NC",
"postal_code": "277072564",
"telephone_number": "919-627-8442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOONE",
"first_name": "ANNE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-19",
"last_updated": "2010-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "2825",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6000866",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2290464",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.