Individual provider Active NPI

Willie Floyd McBride III, PHD

  • Clinical Psychologist
  • Lexington, KY
National Provider Identifier
1912460247
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
271213 Issued in KY
Practice address
740 S Limestone Ste B101
Lexington, KY 40536-2213
Phone
(859) 323-5661
Fax
(859) 323-6411
NPI assigned
Apr 12, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X 271213 KY
Clinical Psychologist 103TC0700X 271213 KY Primary

Addresses

Primary practice location

740 S Limestone Ste B101
Lexington, KY 40536-2213

Mailing address

851 S 4TH St
Louisville, KY 40203-2115
Phone (502) 873-4171

Other practice location 1

845 S 3rd St Rm 302
Louisville, KY 40203-2213
Phone (502) 873-4171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20250714002374 KY Practitioner - Clinical Psychologist 5890200448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of KentuckyGroup PAC ID 3072425289, 778 clinicians

Practice addresses (Care Compare)

740 S Limestone St
Lexington, KY 40508-0001
Phone (859) 233-5950

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
271213KYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky Single Specialty CurrentSince Jul 1, 2025 Accepting new patients

Locations

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1912460247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 S 4TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402032115",
            "telephone_number": "502-873-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE STE B101",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405362213",
            "telephone_number": "859-323-5661",
            "fax_number": "859-323-6411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "845 S 3rd St Rm 302",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402032213",
            "country_code": "US",
            "telephone_number": "502-873-4171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCBRIDE",
        "first_name": "WILLIE",
        "middle_name": "FLOYD",
        "name_suffix": "III",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-12",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "KY",
            "license": "271213",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "271213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.