Active NPI
Kymmalett Anntyonette Ross, PHD
- Psychologist
- Cary, NC
National Provider Identifier
1871275800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 130 Preston Executive Dr Ste 202
Cary, NC 27513-8433 - Phone
- (931) 302-3638
- NPI assigned
- Aug 1, 2023
- Last updated
- Aug 1, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
130 Preston Executive Dr Ste 202
Cary, NC 27513-8433
Mailing address
10 Cabes Mill Rd
Durham, NC 27705-1405
Phone (931) 302-3638
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690848000000",
"number": "1871275800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 CABES MILL RD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277051405",
"telephone_number": "931-302-3638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 PRESTON EXECUTIVE DR STE 202",
"city": "CARY",
"state": "NC",
"postal_code": "275138433",
"telephone_number": "931-302-3638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "KYMMALETT",
"middle_name": "ANNTYONETTE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-01",
"last_updated": "2023-08-01",
"certification_date": "2023-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cary, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.