Individual provider Active NPI

Matthew Lee Remick, PSY.D.

  • Clinical Psychologist
  • Birmingham, AL
National Provider Identifier
1841393071
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1078 Issued in AL
Practice address
4778 Overton Rd
Birmingham, AL 35210-3803
Phone
(205) 957-0294
Fax
(205) 957-0298
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1078 AL Primary

Addresses

Primary practice location

4778 Overton Rd
Birmingham, AL 35210-3803

Mailing address

4778 Overton Rd
Birmingham, AL 35210-3803
Phone (205) 957-0294

Other identifiers 1

IdentifierTypeStateIssuer
515-28791OtherALBCBS OF AL PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20090507000524 AL Practitioner - Clinical Psychologist 0143378752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3840 Ridgeway Dr
Homewood, AL 35209-5506
Phone (205) 438-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1078ALMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew Remick Psychology, LLC Clinical CurrentSince Jun 1, 2016 Accepting new patients
SVPS Psychiatric Services LLC Past Accepting new patients
Mitchell'S Place, Inc. Clinical Past Accepting new patients
Grayson and Associates PC Clinical PastSince Aug 1, 2008 Accepting new patients

Locations

3840 Ridgeway Dr
Homewood, AL 35209
Phone (205) 206-9860

15 Office Park Cir
Ste 140
Mountain Brk, AL 35223
Phone (205) 208-9628

Organizations & group practices 4

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": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1841393071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4778 OVERTON RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352103803",
            "telephone_number": "205-957-0294",
            "fax_number": "205-957-0298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4778 OVERTON RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352103803",
            "telephone_number": "205-957-0294",
            "fax_number": "205-957-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REMICK",
        "first_name": "MATTHEW",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "1078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL PROVIDER #",
            "identifier": "515-28791",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.