Gary Edward Dudley, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY000520 Issued in GA

Practice address

2520 Windy Hill Rd SE
Suite 203
Marietta, GA 30067-8664

Phone

(770) 953-6401

Fax

(770) 953-6015

NPI assigned

Nov 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

Clinical Psychologist

Education

Other, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atlanta Area Psychological Associates, P.C.Group PAC ID 4587645635, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Atlanta Area Psychological Associates, P.C.

  • Psychologist
  • Marietta, GA
  • NPI 1720131253
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710057294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 WINDY HILL RD SE",
            "address_2": "SUITE 203",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678664",
            "telephone_number": "770-953-6401",
            "fax_number": "770-953-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 WINDY HILL RD SE",
            "address_2": "SUITE 203",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678664",
            "telephone_number": "770-953-6401",
            "fax_number": "770-953-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "GARY",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY000520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000117961F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000117961A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000117961G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000117961H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derek Austin Dubois, NP
• Sequioa Ducasse, D.P.M.
• Kellie Duckworth, CRNA
• Patricia G Duckworth, APRN
• Kendrick Dornell Ducre
• Ifeoluwa Duduyemi, LMSW
• Due West Pharmacy
• Due West Pharmacy, Inc
• Gary C Duey, O.D.
• Jasmine Renae Duff, PT, DPT

• Psychologist in Marietta, GA
• Providers in Marietta, GA by specialty
• Psychologist in Georgia

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.