Individual provider Active NPI

Linda Alice Wilson, PH.D.

  • Clinical Psychologist
  • Columbus, GA
National Provider Identifier
1790840981
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1288 Issued in GA
Practice address
2325 Brookstone Centre Parkway
Columbus, GA 31904
Phone
(706) 653-6841
NPI assigned
Dec 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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 1288 GA Primary

Addresses

Primary practice location

2325 Brookstone Centre Parkway
Columbus, GA 31904

Mailing address

2325 Brookstone Centre Parkway
Columbus, GA 31904
Phone (706) 653-6841

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
I20110301000679 GA Practitioner - Clinical Psychologist 4587677026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Un of California, Irvine, College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Columbus Psychological Associates, LLPGroup PAC ID 8527054162, 12 clinicians

Practice addresses (Care Compare)

2325 Brookstone Centre Pkwy
Columbus, GA 31904-4500
Phone (706) 653-6841

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1288GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Psychological Assoc. PastSince Jun 15, 2017 Accepting new patients
Stephen a. Felker, PH.D., P.C. Clinical PastSince Dec 12, 2021 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790840981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 BROOKSTONE CENTRE PARKWAY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31904",
            "telephone_number": "706-653-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 BROOKSTONE CENTRE PARKWAY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31904",
            "telephone_number": "706-653-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LINDA",
        "middle_name": "ALICE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "1288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.