Brenda Carol Parker, PH.D.
Individual provider Active NPI Clinical Neuropsychologist · Pioneer Village, KY
NPI 1871899062 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1871899062
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Neuropsychologist 103G00000X
- License
- 129682 (KY)
- Practice address
- 815 John Harper Rd Unit 13
Pioneer Village, KY 40165-7463 - Phone
- (502) 504-5231
- Fax
- (502) 504-5205
- NPI assigned
- Feb 4, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Neurology
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
815 John Harper Rd
Pioneer Village, KY 40165-7463
815 John Harper Rd Unit
Suite 13
Pioneer Village, KY 40165-7463
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160809001921 | KY | Practitioner - Clinical Psychologist | 0547554818 | Practice locations: Pioneer Village, KY |
| I20161109002641 | KY | Practitioner - Neurology | 0547554818 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 129682 | KY | MD | Clinical Neuropsychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Neuropsychological Services | Clinical Neuropsychologist | Current |
Accepting new patients |
| Nurse Practitioner Associates, PLLC | Past |
Accepting new patients |
Locations
815 John Harper Rd
Unit 13
Shepherdsville, KY 40165
Phone (502) 504-5231
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 129682 | KY | |
| Clinical Neuropsychologist | 103G00000X | 129682 | KY | Yes |
Addresses
Primary practice location
815 John Harper Rd Unit 13
Pioneer Village, KY 40165-7463
Mailing address
815 John Harper Highway
Ste 13
Pioneer Village, KY 40165-7463
Phone (502) 504-5231
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100315910 | Medicaid | KY | |
| 50109798 | Other | PASSPORT GROUP ID |
Other providers in Pioneer Village, KY
All providers in Pioneer Village, KY · Clinical Neuropsychologist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.