Active NPI
Debra Ann Goldsmith, PH.D.
- Clinical Psychologist
- Thonotosassa, FL
National Provider Identifier
1841471265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY0004674
- Practice address
- 11309 Thonotosassa Rd
Thonotosassa, FL 33592-3031 - Phone
- (813) 982-1268
- Fax
- (813) 982-1306
- NPI assigned
- Nov 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | PY0004674 | FL | Primary |
Addresses
Primary practice location
11309 Thonotosassa Rd
Thonotosassa, FL 33592-3031
Mailing address
11309 Thonotosassa Rd
Thonotosassa, FL 33592-3031
Phone (813) 982-1268
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY0004674 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195084800000",
"number": "1841471265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11309 THONOTOSASSA RD",
"city": "THONOTOSASSA",
"state": "FL",
"postal_code": "335923031",
"telephone_number": "813-982-1268",
"fax_number": "813-982-1306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11309 THONOTOSASSA RD",
"city": "THONOTOSASSA",
"state": "FL",
"postal_code": "335923031",
"telephone_number": "813-982-1268",
"fax_number": "813-982-1306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSMITH",
"first_name": "DEBRA",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-15",
"last_updated": "2007-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY0004674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thonotosassa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.