Individual provider Active NPI

Catherine Drew, PHD

  • Psychologist
  • Fernandina Beach, FL
National Provider Identifier
1679973341
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY9101 Issued in FL
Practice address
1903 Island Walkway
Fernandina Beach, FL 32034-4797
Phone
(904) 277-0027
Fax
(407) 867-6261
NPI assigned
Aug 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY9101 FL Primary

Addresses

Primary practice location

1903 Island Walkway
Fernandina Beach, FL 32034-4797

Mailing address

1903 Island Walkway
Fernandina Beach, FL 32034-4797
Phone (904) 277-0027

Other identifiers 1

IdentifierTypeStateIssuer
001116400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20150806012708 FL Practitioner - Clinical Psychologist 0345553889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Psychological Associates, LLCGroup PAC ID 9436462975, 2 clinicians

Practice addresses (Care Compare)

1903 Island Walk Way
Fernandina Beach, FL 32034-4797
Phone (904) 277-0027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY9101FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Psychological & Associated Healthcare Psychologist PastSince Dec 9, 2024 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1679973341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 ISLAND WALKWAY",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344797",
            "telephone_number": "904-277-0027",
            "fax_number": "407-867-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 ISLAND WALKWAY",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344797",
            "telephone_number": "904-277-0027",
            "fax_number": "407-867-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREW",
        "first_name": "CATHERINE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-29",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY9101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001116400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

Verify at the official NPI Registry.