Active NPI
Judith Marie Pheatt, PHD
- Psychologist
- Toledo, OH
National Provider Identifier
1689784647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 5138
- Practice address
- 3454 Oak Alley CT
305
Toledo, OH 43606-1306 - Phone
- (419) 534-2468
- Fax
- (419) 534-2397
- NPI assigned
- Aug 30, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 5138 | OH | Primary |
Addresses
Primary practice location
3454 Oak Alley CT
305
Toledo, OH 43606-1306
Mailing address
3432 Corey Rd
Toledo, OH 43615-1651
Phone (419) 843-5358
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5138 | OH | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689784647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3432 COREY RD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436151651",
"telephone_number": "419-843-5358",
"fax_number": "419-534-2397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3454 OAK ALLEY CT",
"address_2": "305",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436061306",
"telephone_number": "419-534-2468",
"fax_number": "419-534-2397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHEATT",
"first_name": "JUDITH",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "5138",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.