Individual provider Active NPI

Robin A. Brill, PH.D.

  • Clinical Psychologist
  • Cumming, GA
National Provider Identifier
1720137276
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY002263 Issued in GA
Practice address
5807 Long Park Rd
Cumming, GA 30040-5718
Phone
(770) 886-8488
NPI assigned
Jan 10, 2007
Sex
Female
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
Clinical Psychologist 103TC0700X PSY002263 GA Primary

Addresses

Primary practice location

5807 Long Park Rd
Cumming, GA 30040-5718

Mailing address

5807 Long Park Rd
Cumming, GA 30040-5718
Phone (770) 886-8488

Other identifiers 1

IdentifierTypeStateIssuer
00821906A,CMedicaidGA

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
I20051005000483 GA Practitioner - Clinical Psychologist 1658306972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5807 Long Park Rd
Cumming, GA 30040-5718
Phone (770) 886-8488

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Robin a. Brill, PHD,LLC Clinical CurrentSince Sep 18, 2015 Accepting new patients

Locations

5807 Long Park Rd
Cumming, GA 30040
Phone (470) 508-8955

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720137276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5807 LONG PARK RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300405718",
            "telephone_number": "770-886-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5807 LONG PARK RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300405718",
            "telephone_number": "770-886-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRILL",
        "first_name": "ROBIN",
        "middle_name": "A.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY002263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00821906A,C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.