Organization Active NPI

Rhonda Perdue PHD PA

  • Clinical Psychologist
  • Wellington, FL
National Provider Identifier
1710152780
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY5257 Issued in FL
Legal business name
RHONDA PERDUE PHD PA
Practice address
10111 W Forest Hill Blvd
Suite 369
Wellington, FL 33414-6108
Phone
(561) 784-7767
NPI assigned
Apr 29, 2008
Organization subpart
Yes
Parent organization
RHONDA PERDUE PHD PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Authorized official

Name
Karl Perdue
Title
Vice President
Phone
(561) 271-4394

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY5257 FL Primary

Addresses

Primary practice location

10111 W Forest Hill Blvd
Suite 369
Wellington, FL 33414-6108

Mailing address

10111 W Forest Hill Blvd
Suite 369
Wellington, FL 33414-6108
Phone (561) 784-7767

Other identifiers 1

IdentifierTypeStateIssuer
K8783OtherFLMEDICARE GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051028000493 FL Part B Supplier - Clinic/Group Practice 5890712863 Receives reassigned benefits from 1 practitioner
Practice locations: Wellington, FL

National Provider Directory

National Provider Directory
Part of
Rhonda Perdue PHD PA

Locations

10111 Forest Hill Blvd
Rm 369
West Palm Bch, FL 33414
Phone (561) 784-7767

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209513600000",
    "number": "1710152780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10111 W FOREST HILL BLVD",
            "address_2": "SUITE 369",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146108",
            "telephone_number": "561-784-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10111 W FOREST HILL BLVD",
            "address_2": "SUITE 369",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146108",
            "telephone_number": "561-784-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RHONDA PERDUE PHD PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RHONDA PERDUE PHD PA",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-04-30",
        "status": "A",
        "authorized_official_last_name": "PERDUE",
        "authorized_official_first_name": "KARL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "561-271-4394"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY5257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "K8783",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.