Individual provider Active NPI

Whatley Battey Fenlon, PH.D.

  • Psychologist
  • Stockbridge, GA
National Provider Identifier
1700950631
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
800 Issued in GA
Practice address
240 Corporate Center Dr
Stockbridge, GA 30281-7214
Phone
(404) 483-5605
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 800 GA Primary

Addresses

Primary practice location

240 Corporate Center Dr
Stockbridge, GA 30281-7214

Mailing address

1139 Alta Ave NE
Atlanta, GA 30307-2572
Phone (404) 483-5606

Other identifiers 1

IdentifierTypeStateIssuer
000244384AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20050629000714 GA Practitioner - Clinical Psychologist 3870539919 Practice locations: Stockbridge, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

120 Martin Luther King Senior
Suite 109
Stockbridge, GA 30281

120 Martin Luther King Senior Heritage Trail
Suite 109
Stockbridge, GA 30281

120 Martin Luther King Sr Heritage TR
Suite 109
Stockbridge, GA 30281
Phone (770) 506-8187

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
800GAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Accord Psychological Associates Past Accepting new patients

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700950631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1139 ALTA AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303072572",
            "telephone_number": "404-483-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 CORPORATE CENTER DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817214",
            "telephone_number": "404-483-5605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENLON",
        "first_name": "WHATLEY",
        "middle_name": "BATTEY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000244384A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.