Psychological Medicine Clinic PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PSYCHOLOGICAL MEDICINE CLINIC PLLC

Practice address

1810 Westwood Ave W
Wilson, NC 27893-2143

Phone

(252) 291-6200

Fax

(252) 291-2147

NPI assigned

Feb 9, 2007

Organization subpart

No

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

Authorized official

Name

Krishna M Verma, M.D.NPI 1164517447

Title

MD - Psychiatrist

Phone

(252) 291-6200

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Krishna Murari Verma, M.D.

  • Psychiatry Physician
  • Wilson, NC
  • NPI 1164517447
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384387200000",
    "number": "1972644219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 WESTWOOD AVE W",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278932143",
            "telephone_number": "252-291-6200",
            "fax_number": "252-291-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 WESTWOOD AVE W",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278932143",
            "telephone_number": "252-291-6200",
            "fax_number": "252-291-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL MEDICINE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2013-11-14",
        "status": "A",
        "authorized_official_last_name": "VERMA",
        "authorized_official_first_name": "KRISHNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MD - PSYCHIATRIST",
        "authorized_official_telephone_number": "252-291-6200",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE P-TAN",
            "identifier": "2157403B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8985003",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Progressive Healthcare & Counseling Services Inc.
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• Prophetice Vision Care
• David C Propst, PA-C
• Madison Rose Propst, LCSWA
• Psychological Mobile Services, PA
• Sonya Purushothaman, M.D.
• Amanda Suydam Purvis, LCSWA
• Shawn C Putman, MD
• Kathryn Gibbons Putney, D.D.S

• Specialist in Wilson, NC
• Providers in Wilson, NC by specialty
• Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.