NPIMap

Organization Active NPI

Rector & Visitors of the University of Virginia

Doing business as University of Virginia Center for Clinical Psychology Services

  • Clinical Psychologist
  • Charlottesville, VA
National Provider Identifier
1710193552
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
103TCO700X Issued in VA
Legal business name
RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA
Doing business as
University of Virginia Center for Clinical Psychology Services
Practice address
417 Emmet Street, South
Charlottesville, VA 22904-4270
Phone
(434) 924-7034
Fax
(434) 924-4621
NPI assigned
May 16, 2007
Last updated
Aug 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Authorized official

Name
Patty H Carpenter
Title
Center Manager
Phone
(434) 924-1406

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 103TCO700X VA Primary

Addresses

Primary practice location

417 Emmet Street, South
Charlottesville, VA 22904-4270

Mailing address

417 Emmet Street, South
P.O. Box 400270
Charlottesville, VA 22904-4270
Phone (434) 924-7034

Other identifiers 2

IdentifierTypeStateIssuer
274981000OtherVAMAGELLAN
230305OtherVAANTHEM BCBS

Other names 1

  • University of Virginia Center for Clinical Psychology Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031118000066 VA Part B Supplier - Clinic/Group Practice 4789592718 Receives reassigned benefits from 126 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Charlottesville, VA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Prosthetics and Orthotiipl45 organizations share this tax ID, including this one

Other organizations with this tax ID 44

Organizations that report the same tax identification number in the National Provider Directory.

View all 44

Locations

2955 Ivy Rd
Ste 201
Charlottesvle, VA 22903
Phone (434) 243-4520

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1710193552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 EMMET STREET, SOUTH",
            "address_2": "P.O. BOX 400270",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229044270",
            "telephone_number": "434-924-7034",
            "fax_number": "434-924-4621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 EMMET STREET, SOUTH",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229044270",
            "telephone_number": "434-924-7034",
            "fax_number": "434-924-4621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "PATTY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CENTER MANAGER",
        "authorized_official_telephone_number": "434-924-1406"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "103TCO700X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "274981000",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "230305",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University of Virginia Center for Clinical Psychology Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.