Individual provider Active NPI

Malinda Isaacs, PH.D.

  • Psychologist
  • Sarasota, FL
National Provider Identifier
1750689725
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
KY1569 Issued in KY
Practice address
1090 S Tamiami TRL Ste 215
Sarasota, FL 34236-9116
Phone
(941) 363-0878
Fax
(859) 963-1721
NPI assigned
Mar 1, 2011
Last updated
Feb 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X KY1569 KY Primary

Addresses

Primary practice location

1090 S Tamiami TRL Ste 215
Sarasota, FL 34236-9116

Mailing address

1090 S Tamiami TRL
Sarasota, FL 34236-9116
Phone (941) 363-0878

Other practice location 1

480 Lexington Rd
Versailles, KY 40383-1918
Phone (859) 429-1709

Other names 1

  • Mindy Martin Sudduth Isaacs Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
KY1569KYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1298937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1750689725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 S TAMIAMI TRL",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342369116",
            "telephone_number": "941-363-0878",
            "fax_number": "859-963-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 S TAMIAMI TRL STE 215",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342369116",
            "telephone_number": "941-363-0878",
            "fax_number": "859-963-1721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "480 Lexington Rd",
            "address_purpose": "LOCATION",
            "city": "Versailles",
            "state": "KY",
            "postal_code": "403831918",
            "country_code": "US",
            "telephone_number": "859-429-1709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISAACS",
        "first_name": "MALINDA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-01",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "KY1569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MINDY",
            "last_name": "ISAACS",
            "middle_name": "MARTIN SUDDUTH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; 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.