PONTE VEDRA NEUROPSYCHOLOGY LLC
NPI 1114624277
Clinical Neuropsychologist in Ponte Vedra Beach, FL

Q: What is Ponte Vedra Neuropsychology LLC's NPI number?

The NPI number for Ponte Vedra Neuropsychology LLC is 1114624277. It was assigned to this organization in the NPPES registry on February 9, 2023.

Q: What is Ponte Vedra Neuropsychology LLC's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Active since February 09, 2023

100 EXECUTIVE WAY STE 212, PONTE VEDRA BEACH, FL 32082(904) 709-4542 Get Directions Write a Review

NPPES record last updated: August 4, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 4, 2026, Feb 9, 2023 (2 updates tracked since 2023).

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About Ponte Vedra Neuropsychology Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PONTE VEDRA NEUROPSYCHOLOGY LLC (NPI 1114624277) is a healthcare organization registered as a clinical neuropsychologist in Ponte Vedra Beach, Florida and active in the NPI registry since February 2023. The organization lists Kari Eng, Neuropsychologist / Owner, as its authorized official.

NPPES Registry Identity

NPI1114624277

Entity TypeOrganization

Primary Taxonomy103G00000X

Legal Business NamePONTE VEDRA NEUROPSYCHOLOGY LLC

Location Address100 EXECUTIVE WAY STE 212Ponte Vedra Beach, FL 32082-2714

Mailing Address176 Parkbluff CirPonte Vedra, FL 32081-0958 · (904) 303-8362

Phone(904) 709-4542

Organization SubpartNo

Authorized OfficialKari EngNeuropsychologist / Owner · (904) 303-8362

Enumeration DateFebruary 9, 2023

Last NPPES UpdateAugust 4, 20262 updates tracked since enumeration

NPPES CertifiedAugust 4, 2026

✔ NPI 1114624277 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X

100 EXECUTIVE WAY STE 212, Ponte Vedra Beach, FL 32082

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ponte Vedra Neuropsychology Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Ponte Vedra Neuropsychology LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kari Eng, PSYD

Clinical Psychologist

NPI 1356591366

100 EXECUTIVE WAY STE 212
Ponte Vedra Beach, FL 32082

(904) 709-4542

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ponte Vedra Neuropsychology LLC's NPI number?

The NPI number for Ponte Vedra Neuropsychology LLC is 1114624277. It was assigned to this organization in the NPPES registry on February 9, 2023.

Where is Ponte Vedra Neuropsychology LLC located?

Ponte Vedra Neuropsychology LLC is located at 100 Executive Way Ste 212, Ponte Vedra Beach, FL 32082. The listed phone number is (904) 709-4542.

What is Ponte Vedra Neuropsychology LLC's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Ponte Vedra Neuropsychology LLC enrolled in Medicare?

Yes. Ponte Vedra Neuropsychology LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Ponte Vedra Neuropsychology LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Ponte Vedra Neuropsychology LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Ponte Vedra Neuropsychology LLC was last updated on August 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.