Organization Active NPI

Robin a Avery PHD PLLC

  • Clinical Neuropsychologist
  • Miami Shores, FL
National Provider Identifier
1801298997
Registry record updated Sep 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
ROBIN A AVERY PHD PLLC
Practice address
9999 NE 2ND Ave
Suite 209E
Miami Shores, FL 33138-2352
Phone
(786) 615-4758
NPI assigned
Sep 19, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2014

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

Authorized official

Name
Robin A Avery, PHDNPI 1407263999
Title
President
Phone
(305) 992-0370

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X Primary

Addresses

Primary practice location

9999 NE 2ND Ave
Suite 209E
Miami Shores, FL 33138-2352

Mailing address

10618 NE 10TH PL
Miami Shores, FL 33138-2104
Phone (305) 992-0370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20141006002037 FL Part B Supplier - Clinic/Group Practice 3678793007 Receives reassigned benefits from 1 practitioner
Practice locations: Miami Shores, FL
O20260602003364 NC Part B Supplier - Clinic/Group Practice 3678793007 Receives reassigned benefits from 1 practitioner
Practice locations: Candler, NC; Arden, NC

National Provider Directory

National Provider Directory

Locations

9999 NE 2nd Ave
#209E
Miami Shores, FL 33138
Phone (786) 615-4758

9999 NE 2nd Ave
Ste 209E
Miami Shores, FL 33138
Phone (786) 615-4758

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411084800000",
    "number": "1801298997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10618 NE 10TH PL",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331382104",
            "telephone_number": "305-992-0370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9999 NE 2ND AVE",
            "address_2": "SUITE 209E",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331382352",
            "telephone_number": "786-615-4758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBIN A AVERY PHD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-19",
        "last_updated": "2014-09-19",
        "status": "A",
        "authorized_official_last_name": "AVERY",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-992-0370",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Shores, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.