Organization Active NPI

Vericare, P.C.

Doing business as VeriCare

  • Clinical Psychologist
  • Dallas, TX
National Provider Identifier
1740238260
Registry record updated Jul 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
VERICARE, P.C.
Doing business as
VeriCare
Practice address
8059 Scyene Cir
Dallas, TX 75227-5562
Phone
(800) 257-8715
Fax
(800) 819-1655
NPI assigned
May 5, 2006
Reactivated
Aug 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2017

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

Authorized official

Name
Melissa King
Title
Director, Credentialing Enrollment
Phone
(800) 370-3651

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

8059 Scyene Cir
Dallas, TX 75227-5562

Mailing address

55 Hatchetts Hill Rd
Old Lyme, CT 06371-1534
Phone (800) 370-3651

Other identifiers 2

IdentifierTypeStateIssuer
CB3582OtherTXRAILROAD MEDICARE
136136211MedicaidTX

Other names 1

  • VeriCare Doing business as

National Provider Directory

National Provider Directory

Locations

55 Hatchetts Hill Rd
Old Lyme, CT 06371
Phone (510) 919-8897

1950 Record Crossing Rd
#3582
Dallas, TX 75235
Phone (214) 330-9291

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499644800000",
    "number": "1740238260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 HATCHETTS HILL RD",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063711534",
            "telephone_number": "800-370-3651",
            "fax_number": "877-515-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8059 SCYENE CIR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752275562",
            "telephone_number": "800-257-8715",
            "fax_number": "800-819-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERICARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2017-07-10",
        "deactivation_date": "2007-04-11",
        "reactivation_date": "2007-08-08",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "DIRECTOR, CREDENTIALING ENROLLMENT",
        "authorized_official_telephone_number": "800-370-3651"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB3582",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136136211",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VeriCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.