Phyllis D Ivery, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY003523 Issued in GA

Practice address

655 7TH St BLDG 700700-a
78 MDG/Sgow
Robins Afb, GA 31098-2227

Phone

(478) 327-8398

NPI assigned

Jun 14, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Linda Munro Psy D PA

  • Military Hospital
  • Robins Afb, GA
  • NPI 1689886137
  NPD (past)

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1649532649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 AMBER DR",
            "city": "BYRON",
            "state": "GA",
            "postal_code": "310083876",
            "telephone_number": "678-447-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 7TH ST BLDG 700700-A",
            "address_2": "78 MDG/SGOW",
            "city": "ROBINS AFB",
            "state": "GA",
            "postal_code": "310982227",
            "telephone_number": "478-327-8398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVERY",
        "first_name": "PHYLLIS",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY003523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas C. Holmes, DMD
• HQ Air Force Reserve Command
• Tandra Hunter, LMSW
• Gregory Scott Hyland, MD
• Ethan Irvin, PHYSICIAN ASSISTANT
• Jon Morris Johnson, M.D.
• Stephanie Hillsman Johnson, LCSW
• Valerie V T Johnson, M.D.
• John A Kauderman Jr., OD
• Amy Kilbarger, FNP-C

• Psychologist in Robins Afb, GA
• Providers in Robins Afb, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; 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.