Individual provider Active NPI

Kristin B Webb, PSY.D.

  • Clinical Psychologist
  • Chapel Hill, NC
National Provider Identifier
1801871736
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2639 Issued in NC
Practice address
105 Deerwood CT
Chapel Hill, NC 27517-3406
Phone
(919) 225-1569
NPI assigned
Dec 14, 2005
Last updated
Mar 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2639 NC Primary
Group Psychotherapy Psychologist 103TP2701X 2639 NC

Addresses

Primary practice location

105 Deerwood CT
Chapel Hill, NC 27517-3406

Mailing address

105 Deerwood CT
Chapel Hill, NC 27517-3406
Phone (919) 225-1569

Other identifiers 2

IdentifierTypeStateIssuer
280997OtherNCMANAGED HEALTH NETWORK
045KEOtherNCBLUE CROSS BLUE SHIELD NC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20110218000676 NC Practitioner - Clinical Psychologist 9638350903 Practice locations: Chapel Hill, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

105 Deerwood CT
Chapel Hill, NC 27517-3406
Phone (919) 225-1569

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2639NCMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
County of Durham Finance Dept Past Accepting new patients

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, 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": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1801871736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 DEERWOOD CT",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275173406",
            "telephone_number": "919-225-1569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 DEERWOOD CT",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275173406",
            "telephone_number": "919-225-1569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBB",
        "first_name": "KRISTIN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2639",
            "primary": true
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NC",
            "license": "2639",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "280997",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "045KE",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.