Individual provider Active NPI

Brad Prinzhorn

  • Clinical Psychologist
  • Durham, NC
National Provider Identifier
1982682910
Registry record updated Nov 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2789 Issued in NC
Practice address
2670 Durham Chapel Hill Blvd
Durham, NC 27707-2829
Phone
(919) 251-9001
Fax
(919) 251-9008
NPI assigned
Jan 9, 2006
Last updated
Nov 1, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2789 NC
Mental Health Counselor 101YM0800X 2789 NC
Clinical Psychologist 103TC0700X 2789 NC Primary

Addresses

Primary practice location

2670 Durham Chapel Hill Blvd
Durham, NC 27707-2829

Mailing address

2670 Durham Chapel Hill Blvd
Durham, NC 27707-2829
Phone (919) 251-9001

Other identifiers 1

IdentifierTypeStateIssuer
6000249MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20070927000677 NC Practitioner - Clinical Psychologist 8921192568 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chapel Hill Psychiatric Associates, P.a.Group PAC ID 6305930942, 6 clinicians

Practice addresses (Care Compare)

610 Jones Ferry Rd
Suite 208
Carrboro, NC 27510-6113
Phone (919) 636-5695

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Outreach, LLC Current Accepting new patients
Carolina Outreach, LLC Mental Health CurrentSince Jul 20, 2014 Accepting new patients
Mindpath Care Centers, North Carolina, PLLC Mental Health PastSince Sep 26, 2015 Accepting new patients

Locations

2670 Durham Chapel Hill Blvd
Durham, NC 27707
Phone (919) 251-9009

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1982682910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 DURHAM CHAPEL HILL BLVD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072829",
            "telephone_number": "919-251-9001",
            "fax_number": "919-251-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 DURHAM CHAPEL HILL BLVD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072829",
            "telephone_number": "919-251-9001",
            "fax_number": "919-251-9008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINZHORN",
        "first_name": "BRAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "2789",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "2789",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000249",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.