Individual provider Active NPI

Jill Ann Carty, PSY.D.

  • Clinical Psychologist
  • Falls Church, VA
National Provider Identifier
1033489901
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
810003365 Issued in VA
Practice address
5113 Leesburg Pike
Skyline 4, Suite800A
Falls Church, VA 22041
Phone
(703) 845-3317
NPI assigned
Jan 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 810003365 VA Primary

Addresses

Primary practice location

5113 Leesburg Pike
Skyline 4, Suite800A
Falls Church, VA 22041

Mailing address

10907 Hunter Station Rd
Vienna, VA 22181-2817
Phone (703) 865-7070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20260514002924 VA Practitioner - Clinical Psychologist 2264901644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sailor Health Medical PAGroup PAC ID 4486182342, 301 clinicians

Practice addresses (Care Compare)

1545 Crossways Blvd
Suite 250
Chesapeake, VA 23320-0218
Phone (240) 200-0173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
810003365VAMDClinical Psychologist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326067200000",
    "number": "1033489901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10907 HUNTER STATION RD",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221812817",
            "telephone_number": "703-865-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5113 LEESBURG PIKE",
            "address_2": "SKYLINE 4, SUITE800A",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "22041",
            "telephone_number": "703-845-3317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTY",
        "first_name": "JILL",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-09",
        "last_updated": "2012-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "810003365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

Verify at the official NPI Registry.