Individual provider Active NPI

Emily B. McNally, PHD

  • Psychologist
  • Fort Myers, FL
National Provider Identifier
1801034145
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35SI00302300 Issued in NJ
Practice address
12791 World Plaza LN BLDG 89
Fort Myers, FL 33907-3989
Phone
(239) 829-5494
NPI assigned
Jan 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35SI00302300 NJ Primary

Addresses

Primary practice location

12791 World Plaza LN BLDG 89
Fort Myers, FL 33907-3989

Mailing address

3332 Amelia Run Way
Fort Myers, FL 33917-7122
Phone (239) 543-8194

Other practice location 1

3332 Amelia Run Way
Fort Myers, FL 33917-7122
Phone (239) 543-8194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190725000800 FL Practitioner - Clinical Psychologist 8426384686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fort Myers Psychology PAGroup PAC ID 6204936305, 9 clinicians

Practice addresses (Care Compare)

12791 World Plaza LN
BLDG 89
Fort Myers, FL 33907-3989
Phone (239) 829-5494

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35SI00302300NJMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Myers Psychology, PA CurrentSince Jul 2, 2019 Accepting new patients

Locations

15950 McGregor Blvd
Fort Myers, FL 33908
Phone (239) 454-1277

12791 World Plaza Ln
Bldg 89
Fort Myers, FL 33907
Phone (239) 247-1756

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": "1232755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1801034145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3332 AMELIA RUN WAY",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339177122",
            "telephone_number": "239-543-8194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12791 WORLD PLAZA LN BLDG 89",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073989",
            "telephone_number": "239-829-5494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3332 Amelia Run Way",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339177122",
            "country_code": "US",
            "telephone_number": "239-543-8194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCNALLY",
        "first_name": "EMILY",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-24",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00302300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.