Individual provider Active NPI

Patricia O'Connell, PH.D.

  • Clinical Neuropsychologist
  • Decatur, GA
National Provider Identifier
1821037953
Registry record updated Sep 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
2771 Issued in GA
Practice address
2440 Lawrenceville Hwy
Suite 200
Decatur, GA 30033-3226
Phone
(678) 984-4619
NPI assigned
Jun 5, 2006
Last updated
Sep 10, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 2771 GA Primary

Addresses

Primary practice location

2440 Lawrenceville Hwy
Suite 200
Decatur, GA 30033-3226

Mailing address

2440 Lawrenceville Hwy
Suite 200
Decatur, GA 30033-3266
Phone (678) 984-4619

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
I20061011000522 GA Practitioner - Clinical Psychologist 9931105145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pate and Culp Psychological AssociatesGroup PAC ID 7810904679, 3 clinicians

Practice addresses (Care Compare)

235 E Ponce de Leon Ave
Decatur, GA 30030-3412
Phone (678) 595-0062

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pate and Culp Psychological Associates CurrentSince Sep 1, 2006 Accepting new patients
Pate & Culp Psychological Associates, L.L.C. Clinical Neuropsychologist Past Accepting new patients

Locations

235 E Ponce de Leon Ave
Ste 200
Decatur, GA 30030
Phone (404) 480-9001

2440 Lawrenceville Hwy
Ste 200
Decatur, GA 30033
Phone (404) 634-3400

Organizations & group practices 2

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284076800000",
    "number": "1821037953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 LAWRENCEVILLE HWY",
            "address_2": "SUITE 200",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333266",
            "telephone_number": "678-984-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 LAWRENCEVILLE HWY",
            "address_2": "SUITE 200",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333226",
            "telephone_number": "678-984-4619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2010-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "GA",
            "license": "2771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.