Joel K Fairbanks, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY0004557 Issued in FL

Practice address

8474 University Parkway
Pensacola, FL 32514

Phone

(850) 384-4125

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Anna L. Buck, P.a.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pensacola, FL
  • NPI 1013413681
  NPD (past)
• Nursing Home Psychological Services of FL LLC

  • Clinical Psychologist
  • Destin, FL
  • NPI 1750673950
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449014400000",
    "number": "1992883417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18487",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325238487",
            "telephone_number": "850-478-1312",
            "fax_number": "850-474-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8474 UNIVERSITY PARKWAY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32514",
            "telephone_number": "850-384-4125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRBANKS",
        "first_name": "JOEL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2015-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY0004557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "104720",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "73807",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter Talaat Helmy Fahim, M.D.
• David L. Fahringer, MD
• Kayleigh Breane Fails, RN
• Brett S Fain
• Lauren Luker Fain, LMHC
• Jerome Paul Fairchild, MD
• Fairfield Dental Center
• Zaakir Faisthalab, DO
• Tara Falde, FNP
• Terry L Fall, OD

• Psychologist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.