Individual provider Active NPI

Angela Diane Ledgerwood, PH.D.

  • Psychologist
  • Hamilton, OH
National Provider Identifier
1689898132
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
P.7299 Issued in OH
Practice address
2250 Pleasant Ave
Hamilton, OH 45015-1135
Phone
(513) 868-1562
NPI assigned
Apr 13, 2007
Last updated
May 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X P.7299 OH Primary

Addresses

Primary practice location

2250 Pleasant Ave
Hamilton, OH 45015-1135

Mailing address

2250 Pleasant Ave
Hamilton, OH 45015-1135
Phone (513) 868-1562

Other identifiers 1

IdentifierTypeStateIssuer
0205811MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: No
  • 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
I20180103001928 OH Practitioner - Clinical Psychologist 6305104969 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P.7299OHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Clinic Outpatient Services Current Accepting new patients
Central Clinic Inc Mental Health Access Point Current Accepting new patients

Locations

311 Albert Sabin Way
Cincinnati, OH 45229
Phone (513) 558-5823

2100 Pleasant Ave
Hamilton, OH 45015
Phone (513) 868-1562

2250 Pleasant Ave
Hamilton, OH 45015
Phone (513) 558-9006

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, 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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1689898132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 PLEASANT AVE",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450151135",
            "telephone_number": "513-868-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 PLEASANT AVE",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450151135",
            "telephone_number": "513-868-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDGERWOOD",
        "first_name": "ANGELA",
        "middle_name": "DIANE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "P.7299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0205811",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, OH

Sources for this page

Verify at the official NPI Registry.