BAMBI LYNN WADELTON (PLHD) – Clinical Psychologist, NPI 1083764039

BAMBI LYNN WADELTON (PLHD) is a healthcare provider. based in Ponte vedra beach, Florida. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PLHD. They hold a License No. PY5636 (FL). The NPI Number for BAMBI LYNN WADELTON (PLHD) is 1083764039

Main info

Female
Sole Proprietor
31 Years Of Experience
Accepts Medicare Assignment
Name
BAMBI LYNN WADELTON (PLHD)
NPI
1083764039
Phone
(904) 280-8555
Address
13000 SAWGRASS VILLAGE CIR
Enumeration Date
11 January 2007
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9548859500
Graduation Year
1995 (31 years ago)
PAC ID
1951759182
Group Practice PAC ID
7719417278
Professional Enrollment ID
I20231129001814
Address ID
FL322578975JA4243XRDXX303
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,602 CLINICAL PSYCHOLOGIST in FL

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Provider Addresses for BAMBI LYNN WADELTON (PLHD)

  • Sawgrass Village Circle, Palm Valley, Ponte Vedra Beach, Saint Johns County, Florida, United States

    SUITE 46

    PONTE VEDRA BEACH, FL 320825016

    Phone: (904) 280-8555

    Fax: (904) 280-8562

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-11-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231129001814IClinical PsychologistFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour3314$0
View full utilization report →

Insurance plans in this area (ZIP 32082)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7719417278View full group profile
NameSpecialtyState
Clinical Social WorkerFL

Reviews

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Frequently asked questions

What is the standard ID for BAMBI LYNN WADELTON (PLHD) in the U.S.?
In the U.S., BAMBI LYNN WADELTON (PLHD) is identified by NPI 1083764039.
Is BAMBI LYNN WADELTON (PLHD)'s NPI status active today?
Active status means BAMBI LYNN WADELTON (PLHD)'s NPI record is not deactivated in the public file.
How should patients interpret BAMBI LYNN WADELTON (PLHD)'s specialty?
The extract shows Clinical Psychologist for BAMBI LYNN WADELTON (PLHD). Clinical services aligned with this taxonomy classification.
Is BAMBI LYNN WADELTON (PLHD) tied to Ponte Vedra Beach, Florida?
If you are local to Ponte Vedra Beach, Florida, BAMBI LYNN WADELTON (PLHD) may be relevant to your search.
Why is information missing for BAMBI LYNN WADELTON (PLHD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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