Robyn Ford Ezzell, MA, LPA

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2256 Issued in NC

Practice address

3812 Rocking Robyn Run
Knightdale, NC 27545-8716

Phone

(919) 266-4358

Fax

(919) 217-0820

NPI assigned

Apr 5, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1861454720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3812 ROCKING ROBYN RUN",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275458716",
            "telephone_number": "919-266-4358",
            "fax_number": "919-217-0820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3812 ROCKING ROBYN RUN",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275458716",
            "telephone_number": "919-266-4358",
            "fax_number": "919-217-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZZELL",
        "first_name": "ROBYN",
        "middle_name": "FORD",
        "name_prefix": "Mrs.",
        "credential": "MA, LPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "2256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6107160",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Knightdale, NC
• Providers in Knightdale, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; 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.

Verify at the official NPI Registry.