Active NPI
James Beaumont, PSYD
- Clinical Psychologist
- College Park, GA
National Provider Identifier
1801806484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 002571
- Practice address
- 1631 Phoenix Blvd Ste 5
College Park, GA 30349-5545 - Phone
- (770) 909-6550
- Fax
- (770) 909-6551
- NPI assigned
- Aug 8, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 002571 | GA | Primary |
Addresses
Primary practice location
1631 Phoenix Blvd Ste 5
College Park, GA 30349-5545
Mailing address
1631 Phoenix Blvd Ste 5
College Park, GA 30349-5545
Phone (770) 909-6550
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002571 | GA | MD | Anesthesiologist Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801806484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1631 PHOENIX BLVD STE 5",
"city": "COLLEGE PARK",
"state": "GA",
"postal_code": "303495545",
"telephone_number": "770-909-6550",
"fax_number": "770-909-6551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1631 PHOENIX BLVD STE 5",
"city": "COLLEGE PARK",
"state": "GA",
"postal_code": "303495545",
"telephone_number": "770-909-6550",
"fax_number": "770-909-6551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAUMONT",
"first_name": "JAMES",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "002571",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Park, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.