Organization Active NPI

Nancy H. Goldman, LLC

  • Clinical Neuropsychologist
  • Jackson, MS
National Provider Identifier
1023402047
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
R624144 Issued in MS
Legal business name
NANCY H. GOLDMAN, LLC
Practice address
3000 Old Canton Rd
Suite 465
Jackson, MS 39216-4200
Phone
(601) 946-7482
NPI assigned
Mar 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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

Authorized official

Name
Mrs. Nancy H Goldman, PMHCNS,BC
Title
Owner/President
Phone
(601) 946-7482

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X R624144 MS Primary

Addresses

Primary practice location

3000 Old Canton Rd
Suite 465
Jackson, MS 39216-4200

Mailing address

3000 Old Canton Rd
Suite 465
Jackson, MS 39216-4200
Phone (601) 946-7482

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1023402047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 OLD CANTON RD",
            "address_2": "SUITE 465",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164200",
            "telephone_number": "601-946-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 OLD CANTON RD",
            "address_2": "SUITE 465",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164200",
            "telephone_number": "601-946-7482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANCY H. GOLDMAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-27",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "601-946-7482",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PMHCNS,BC"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "MS",
            "license": "R624144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.