Individual provider Active NPI

Michele Cosby, PSY.D

  • Clinical Psychologist
  • Richmond, VA
National Provider Identifier
1689124091
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810004744 Issued in VA
Practice address
5821 Staples Mill Rd
Richmond, VA 23228-5427
Phone
(804) 264-0966
Fax
(804) 264-1029
NPI assigned
Oct 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810004744 VA Primary

Addresses

Primary practice location

5821 Staples Mill Rd
Richmond, VA 23228-5427

Mailing address

5821 Staples Mill Rd
Richmond, VA 23228-5427
Phone (804) 264-0966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20170420001178 VA Practitioner - Clinical Psychologist 3375829682 Reassigns benefits to 1 organization
Practice locations: Richmond, VA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians CurrentSince Mar 1, 2020 Accepting new patients

Locations

1308 Sherwood Ave
Richmond, VA 23220
Phone (804) 828-3129

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487894400000",
    "number": "1689124091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5821 STAPLES MILL RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232285427",
            "telephone_number": "804-264-0966",
            "fax_number": "804-264-1029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5821 STAPLES MILL RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232285427",
            "telephone_number": "804-264-0966",
            "fax_number": "804-264-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSBY",
        "first_name": "MICHELE",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-10",
        "last_updated": "2017-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.