John A. Anderson, PSY.D.
Individual provider Active NPI Clinical Psychologist · Cary, NC
NPI 1902962004 · NPPES record last updated Dec 14, 2017
Key facts
- NPI
- 1902962004
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 2941 (NC)
- Practice address
- 501 Pinner Weald Way Ste 201
Cary, NC 27513-2610 - Phone
- (919) 465-2343
- Fax
- (919) 465-2344
- NPI assigned
- Dec 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
800 Pinner Weald Way
Suite 101
Cary, NC 27513-2607
Phone (919) 465-2343
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180108001894 | NC | Practitioner - Clinical Psychologist | 6103185681 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2941 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John a. Anderson, Psy.D., Inc. | Clinical | Current |
Accepting new patients |
| Wholeheartedly Daring, PLLC | Current |
Accepting new patients |
Locations
800 Pinner Weald Way
Ste 101
Cary, NC 27513
Phone (919) 465-2343
501 Pinner Weald Way
Ste 201
Cary, NC 27513
Phone (919) 465-2343
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2941 | NC | Yes |
Addresses
Primary practice location
501 Pinner Weald Way Ste 201
Cary, NC 27513-2610
Mailing address
1548 Fairbanks Rd
Cary, NC 27513-2705
Phone (919) 468-8398
Other providers in Cary, NC
- Andrea Carrie Anderson
- Christina Anderson
- Courtney Anderson
- Dominique Anderson
- Donna Nicole Anderson
- Kathleen Devon Anderson
- Latoria Rockwell Anderson
- Laura Hill Anderson
- Mary Anderson
- Tyler Evan Anderson
All providers in Cary, NC · Clinical Psychologist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 14, 2017. 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.