Judy Ann Tyson, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1966 Issued in MD

Practice address

8915 Shady Grove CT
Gaithersburg, MD 20877-1308

Phone

(301) 963-0060

Fax

(301) 258-8858

NPI assigned

Jul 13, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2016 through Jul 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Potomac Grove Psychiatry

  • Psychologist
  • Gaithersburg, MD
  • NPI 1912111667
  NPD (past)

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1720086564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8915 SHADY GROVE CT",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771308",
            "telephone_number": "301-963-0060",
            "fax_number": "301-258-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8915 SHADY GROVE CT",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771308",
            "telephone_number": "301-963-0060",
            "fax_number": "301-258-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSON",
        "first_name": "JUDY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-13",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "1966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanya Kelly Turner
• Jean Alexandra Tuttle, LCSW-C
• Monika Marie Twardzik-Roberts, MPT
• Michelle Ekua Serwaa Tweedie, PA-C
• Stacy Tylor, PSY.D.
• Norman David Tzou, MD
• U.S. Medgroup P.a.
• Ucare Agency LLC
• Favour Uchegbu-Rufus
• Tracy Ucuzoglu

• Psychologist in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.