Individual provider Active NPI

Charles M. Buhrman Jr. Jr., PSYD.

  • Psychologist
  • St Petersburg, FL
National Provider Identifier
1669442703
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4324 Issued in OH
Practice address
500 Dr Martin Luther King Jr St N Ste N
St Petersburg, FL 33705-1472
Phone
(727) 357-6447
NPI assigned
Jan 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4324 OH Primary

Addresses

Primary practice location

500 Dr Martin Luther King Jr St N Ste N
St Petersburg, FL 33705-1472

Mailing address

3340 Wood Thrush Dr
Punta Gorda, FL 33950-2620
Phone (859) 291-4800

Other identifiers 1

IdentifierTypeStateIssuer
0903777MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041115001080 OH Practitioner - Clinical Psychologist 2567426083 Reassigns benefits to 1 organization
I20220530000229 FL Practitioner - Clinical Psychologist 2567426083 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
908KYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Charles M. Buhrman, Jr., PSYD, LLC Psychologist CurrentSince Mar 1, 2006 Accepting new patients
University of Cincinnati Physicians Company, LLC Psychologist Past Accepting new patients
Pain Care Institute, LTD. Past Accepting new patients

Locations

19621 Cochran Blvd
Ste 3
Pt Charlotte, FL 33948
Phone (941) 627-9095

2845 Chancellor Dr
Crestview Hills, KY 41017
Phone (859) 341-3412

85 N Grand Ave
Fort Thomas, KY 41075
Phone (859) 572-3100

8549 Montgomery Rd
Cincinnati, OH 45236
Phone (513) 984-3099

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1669442703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 WOOD THRUSH DR",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339502620",
            "telephone_number": "859-291-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DR MARTIN LUTHER KING JR ST N STE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051472",
            "telephone_number": "727-357-6447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUHRMAN JR.",
        "first_name": "CHARLES",
        "middle_name": "M.",
        "name_suffix": "Jr.",
        "credential": "PSYD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "4324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0903777",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.