Joshua Childers, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY004213 Issued in GA

Practice address

507 Ocean Blvd Ste 201
St Simons Island, GA 31522-4819

Phone

(912) 399-9223

Fax

(614) 543-0426

NPI assigned

Apr 24, 2007

Last updated

Jun 23, 2021By the provider in NPPES

Sex

Male

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

Enrolled in MD

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

Specialty

Clinical Psychologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychogeriatric Services LLCGroup PAC ID 6002719226, 122 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Charm City Psychotherapy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lutherville Timonium, MD
  • NPI 1265238471
  Medicare reassignment NPD Authorized official
• Psychogeriatric Services LLC

  • Psychiatry Physician
  • Columbia, MD
  • NPI 1588689483
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1740409473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SAND DOLLAR TRCE",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315223758",
            "telephone_number": "912-399-9223",
            "fax_number": "614-543-0426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 OCEAN BLVD STE 201",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315224819",
            "telephone_number": "912-399-9223",
            "fax_number": "614-543-0426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "JOSHUA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY004213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ralph Cavalier, M.D.
• Centered for Life, Inc
• Amy Lynn Chaffin, APRN, PMHNP-BC
• Rahul Anil Changela, PHARMD
• Stephanie Rene Chapman, D.O.
• Emily K Claros, DPT, PT
• Brandon R Clements, D.M.D.
• Coastal Community Health Services, Inc. (Coastal Community Health St. Simon's Island Pediatrics)
• Coastal Community Retirement Corporation (Marsh's Edge)
• Coastal Community Retirement Corporation

• Clinical Psychologist in St Simons Island, GA
• Providers in St Simons Island, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.